Provider Demographics
NPI:1598053985
Name:PERRY, KAREN S (APN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:S
Last Name:PERRY
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:S
Other - Last Name:KNIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:203 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47403-2504
Mailing Address - Country:US
Mailing Address - Phone:812-668-1946
Mailing Address - Fax:
Practice Address - Street 1:2424 Q ST
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:IN
Practice Address - Zip Code:47421-4734
Practice Address - Country:US
Practice Address - Phone:812-279-4477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-19
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71003646A363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health