Provider Demographics
NPI:1942414701
Name:KOEPPE, KAREN KRAUSE (RD)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:KRAUSE
Last Name:KOEPPE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2180 STEEPLECHASE DR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-6033
Mailing Address - Country:US
Mailing Address - Phone:734-995-1852
Mailing Address - Fax:
Practice Address - Street 1:3174 PACKARD ST
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-1947
Practice Address - Country:US
Practice Address - Phone:734-971-1073
Practice Address - Fax:734-971-8545
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered