Provider Demographics
NPI:1902021215
Name:BLAIR, KAREN SAUNDERS (CANP)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:SAUNDERS
Last Name:BLAIR
Suffix:
Gender:F
Credentials:CANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1
Mailing Address - Street 2:
Mailing Address - City:TIGER
Mailing Address - State:GA
Mailing Address - Zip Code:30576-0001
Mailing Address - Country:US
Mailing Address - Phone:706-782-3877
Mailing Address - Fax:706-212-0296
Practice Address - Street 1:19 JO DOTSON CIR
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:GA
Practice Address - Zip Code:30525-5007
Practice Address - Country:US
Practice Address - Phone:706-212-0028
Practice Address - Fax:706-212-0296
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN031448363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health