Provider Demographics
NPI:1679830947
Name:KARNES, BROOKE K
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:K
Last Name:KARNES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 E JEFFERSON BLVD
Mailing Address - Street 2:STE.104
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46617-3112
Mailing Address - Country:US
Mailing Address - Phone:574-232-5815
Mailing Address - Fax:574-289-4327
Practice Address - Street 1:919 E JEFFERSON BLVD
Practice Address - Street 2:STE.104
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46617-3112
Practice Address - Country:US
Practice Address - Phone:574-232-5815
Practice Address - Fax:574-289-4327
Is Sole Proprietor?:No
Enumeration Date:2012-04-11
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist