Provider Demographics
NPI:1982652152
Name:MOGG, KAREN E (NP)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:E
Last Name:MOGG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2100 E CALVADA BLVD
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048-5805
Mailing Address - Country:US
Mailing Address - Phone:775-727-7535
Mailing Address - Fax:775-751-6416
Practice Address - Street 1:2100 E CALVADA BLVD
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-5805
Practice Address - Country:US
Practice Address - Phone:775-727-7535
Practice Address - Fax:775-751-6416
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704141964363L00000X
NVAPRN001686363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner