Provider Demographics
NPI:1518242650
Name:MAZE, KAREN R
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:R
Last Name:MAZE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 HOSPITAL RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WINCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37398-2472
Mailing Address - Country:US
Mailing Address - Phone:931-967-9680
Mailing Address - Fax:931-967-7362
Practice Address - Street 1:186 HOSPITAL RD
Practice Address - Street 2:SUITE 300
Practice Address - City:WINCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37398-2472
Practice Address - Country:US
Practice Address - Phone:931-967-9680
Practice Address - Fax:931-967-7362
Is Sole Proprietor?:No
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16176363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily