Provider Demographics
NPI:1508065723
Name:BAUDOUINE, KAREN MARIE (BSN)
Entity Type:Individual
Prefix:MISS
First Name:KAREN
Middle Name:MARIE
Last Name:BAUDOUINE
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 HANCOCK RD
Mailing Address - Street 2:
Mailing Address - City:BULLHEAD CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86442-5946
Mailing Address - Country:US
Mailing Address - Phone:928-704-2500
Mailing Address - Fax:928-704-2504
Practice Address - Street 1:3101 DESERT SKY DR
Practice Address - Street 2:
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442-8684
Practice Address - Country:US
Practice Address - Phone:928-704-2500
Practice Address - Fax:928-704-2504
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN094657163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ588163OtherAHCCCS