Provider Demographics
NPI:1730315854
Name:DOWELL, KAREN JEAN
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:JEAN
Last Name:DOWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HEAVENLY
Other - Middle Name:HOME
Other - Last Name:HEALTH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:123 A GRANDVIEW AVENUE
Mailing Address - Street 2:
Mailing Address - City:TILTONSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43963-1079
Mailing Address - Country:US
Mailing Address - Phone:740-317-6366
Mailing Address - Fax:740-859-4488
Practice Address - Street 1:123 A GRANDVIEW AVENUE
Practice Address - Street 2:
Practice Address - City:TILTONSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43963-1079
Practice Address - Country:US
Practice Address - Phone:740-317-6366
Practice Address - Fax:740-859-4488
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH52750870172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker