Provider Demographics
NPI:1891739074
Name:GAYTON, KAREN (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:GAYTON
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 E AVENUE C
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-3942
Mailing Address - Country:US
Mailing Address - Phone:701-323-0750
Mailing Address - Fax:701-323-0753
Practice Address - Street 1:425 E AVENUE C
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-3942
Practice Address - Country:US
Practice Address - Phone:701-323-0750
Practice Address - Fax:701-323-0753
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDND670225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND22614OtherBCBS
NDP83480Medicare UPIN