Provider Demographics
NPI:1629044318
Name:POE, KAREN ANN (MSNFNPRNBSNBC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ANN
Last Name:POE
Suffix:
Gender:F
Credentials:MSNFNPRNBSNBC
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:ANN
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:RR 1 BOX 63A
Mailing Address - Street 2:
Mailing Address - City:DOWNING
Mailing Address - State:MO
Mailing Address - Zip Code:63536-9722
Mailing Address - Country:US
Mailing Address - Phone:660-379-2661
Mailing Address - Fax:
Practice Address - Street 1:RR 1 BOX 63A
Practice Address - Street 2:
Practice Address - City:DOWNING
Practice Address - State:MO
Practice Address - Zip Code:63536-9722
Practice Address - Country:US
Practice Address - Phone:660-379-2661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO111429363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner