Provider Demographics
NPI:1609843770
Name:GRIFFIN, KAREN SUE (PA C)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:SUE
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:PA C
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:SUE
Other - Last Name:PFUNDHENER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA C
Mailing Address - Street 1:1632 ROBY RD
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:WI
Mailing Address - Zip Code:53589-1273
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1632 ROBY RD
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:WI
Practice Address - Zip Code:53589-1273
Practice Address - Country:US
Practice Address - Phone:608-877-2660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI277363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical