Provider Demographics
NPI:1336440460
Name:GOEHRING KARN, KATHARINE ANNE (LMT)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:ANNE
Last Name:GOEHRING KARN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1816 50TH ST S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-7742
Mailing Address - Country:US
Mailing Address - Phone:701-446-7712
Mailing Address - Fax:
Practice Address - Street 1:550 13TH AVE E
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-3360
Practice Address - Country:US
Practice Address - Phone:701-364-2739
Practice Address - Fax:701-373-0037
Is Sole Proprietor?:No
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND959174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist