Provider Demographics
NPI: | 1710956099 |
---|---|
Name: | HAWES, KAREN S (ARNP) |
Entity Type: | Individual |
Prefix: | |
First Name: | KAREN |
Middle Name: | S |
Last Name: | HAWES |
Suffix: | |
Gender: | F |
Credentials: | ARNP |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 1133 COLLEGE AVE |
Mailing Address - Street 2: | SUITE E110 |
Mailing Address - City: | MANHATTAN |
Mailing Address - State: | KS |
Mailing Address - Zip Code: | 66502-2770 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 785-537-2651 |
Mailing Address - Fax: | 785-537-4276 |
Practice Address - Street 1: | 1133 COLLEGE AVE |
Practice Address - Street 2: | SUITE E110 |
Practice Address - City: | MANHATTAN |
Practice Address - State: | KS |
Practice Address - Zip Code: | 66502-2770 |
Practice Address - Country: | US |
Practice Address - Phone: | 785-537-2651 |
Practice Address - Fax: | 785-537-4276 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-03-17 |
Last Update Date: | 2012-11-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
KS | 44601 | 363LF0000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
KS | 068002178 | Other | MEDICARE PTAN |
KS | 100297630B | Medicaid | |
KS | 100297630D | Medicaid | |
KS | S49591 | Medicare UPIN | |
KS | 160721 | Medicare ID - Type Unspecified |