Provider Demographics
NPI:1437627643
Name:BYRNES, KAREN (RN, BSN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:BYRNES
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HANCOCK VA CBOC
Mailing Address - Street 2:787 MARKET ST. SUITE 9
Mailing Address - City:HANCOCK
Mailing Address - State:MI
Mailing Address - Zip Code:49930
Mailing Address - Country:US
Mailing Address - Phone:906-482-7762
Mailing Address - Fax:
Practice Address - Street 1:HANCOCK VA CBOC
Practice Address - Street 2:787 MARKET ST. SUITE 9
Practice Address - City:HANCOCK
Practice Address - State:MI
Practice Address - Zip Code:49930
Practice Address - Country:US
Practice Address - Phone:906-482-7762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704154223163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4704154223OtherREGISTERED NURSE