Provider Demographics
NPI:1477653327
Name:KARLSON, KAREN E (ATC)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:E
Last Name:KARLSON
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 SUMMIT AVE # 5003
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-1048
Mailing Address - Country:US
Mailing Address - Phone:651-962-5971
Mailing Address - Fax:651-962-5981
Practice Address - Street 1:2115 SUMMIT AVE # 5003
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105-1048
Practice Address - Country:US
Practice Address - Phone:651-962-5971
Practice Address - Fax:651-962-5981
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN13572255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer