Provider Demographics
NPI:1457470015
Name:BEETS, KAREN PHILLIPS (FNP)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:PHILLIPS
Last Name:BEETS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 565
Mailing Address - Street 2:
Mailing Address - City:MAYNARDVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37807-0565
Mailing Address - Country:US
Mailing Address - Phone:865-992-3031
Mailing Address - Fax:865-992-8103
Practice Address - Street 1:7701 CORRYTON RD
Practice Address - Street 2:
Practice Address - City:CORRYTON
Practice Address - State:TN
Practice Address - Zip Code:37721-2630
Practice Address - Country:US
Practice Address - Phone:865-247-6263
Practice Address - Fax:865-992-8103
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000006290363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ006174Medicaid
P67799Medicare UPIN
TN103504I181Medicare PIN
TNQ006174Medicaid