Provider Demographics
NPI:1558607200
Name:BOZWELL, KAREN T (ARNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:T
Last Name:BOZWELL
Suffix:
Gender:F
Credentials:ARNP
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 305
Mailing Address - Street 2:
Mailing Address - City:CORYDON
Mailing Address - State:IA
Mailing Address - Zip Code:50060-0305
Mailing Address - Country:US
Mailing Address - Phone:641-872-2260
Mailing Address - Fax:641-872-3116
Practice Address - Street 1:515 W WALL ST
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:IA
Practice Address - Zip Code:52590-1333
Practice Address - Country:US
Practice Address - Phone:641-898-2898
Practice Address - Fax:641-898-2820
Is Sole Proprietor?:No
Enumeration Date:2012-12-28
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA111110363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily