Provider Demographics
NPI:1669824470
Name:MEENAN, KAREN J (NP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:J
Last Name:MEENAN
Suffix:
Gender:F
Credentials:NP
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:4200 LITTLE BLUE PKWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64057-8312
Mailing Address - Country:US
Mailing Address - Phone:816-353-2700
Mailing Address - Fax:816-795-7311
Practice Address - Street 1:1930 N BUSINESS ROUTE 5 UNIT 1A
Practice Address - Street 2:
Practice Address - City:CAMDENTON
Practice Address - State:MO
Practice Address - Zip Code:65020-2659
Practice Address - Country:US
Practice Address - Phone:573-346-5624
Practice Address - Fax:573-346-1957
Is Sole Proprietor?:No
Enumeration Date:2016-07-05
Last Update Date:2022-01-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2016022501363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOPENDINGMedicaid
MOPENDINGMedicare PIN