Provider Demographics
NPI:1649242777
Name:DANIEL, KAREN JOY (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:JOY
Last Name:DANIEL
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:4457 BUCKINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-6223
Mailing Address - Country:US
Mailing Address - Phone:734-637-9791
Mailing Address - Fax:
Practice Address - Street 1:16001 W 9 MILE
Practice Address - Street 2:PROVIDENCE HOSPITAL
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4803
Practice Address - Country:US
Practice Address - Phone:248-849-3331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601004644363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant