Provider Demographics
NPI:1982207627
Name:HENRY, KAREN LYNN
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:LYNN
Last Name:HENRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:LYNN
Other - Last Name:JACK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5573 TIFFANY LN
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45502-6303
Mailing Address - Country:US
Mailing Address - Phone:520-730-1144
Mailing Address - Fax:
Practice Address - Street 1:5573 TIFFANY LN
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45502-6303
Practice Address - Country:US
Practice Address - Phone:520-730-1144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide