Provider Demographics
NPI:1588683759
Name:AUVENSHINE, KAREN RAYFIELD (APRN, BC)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:RAYFIELD
Last Name:AUVENSHINE
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:ELAINE
Other - Last Name:AUVENSHINE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN,BC
Mailing Address - Street 1:1 FREEDOM WAY
Mailing Address - Street 2:(261)
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904-6258
Mailing Address - Country:US
Mailing Address - Phone:706-733-0188
Mailing Address - Fax:706-481-6734
Practice Address - Street 1:1 FREEDOM WAY
Practice Address - Street 2:(261)
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-6258
Practice Address - Country:US
Practice Address - Phone:706-733-0188
Practice Address - Fax:706-481-6734
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN043527364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult