Provider Demographics
NPI:1457109837
Name:PASCHKE, KARONA (FNP-C)
Entity Type:Individual
Prefix:
First Name:KARONA
Middle Name:
Last Name:PASCHKE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1513 STATE ROAD K
Mailing Address - Street 2:
Mailing Address - City:WINDYVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65783-9108
Mailing Address - Country:US
Mailing Address - Phone:417-389-5201
Mailing Address - Fax:
Practice Address - Street 1:1155 W PARKVIEW ST STE 1C
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:MO
Practice Address - Zip Code:65613-7800
Practice Address - Country:US
Practice Address - Phone:417-326-7246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024006684363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner