Provider Demographics
NPI:1669916151
Name:BUCHANAN, KAREN DENISE (APRN)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:DENISE
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:562 DURAM RD
Mailing Address - Street 2:
Mailing Address - City:OLIVE BRANCH
Mailing Address - State:MS
Mailing Address - Zip Code:38654-6819
Mailing Address - Country:US
Mailing Address - Phone:901-516-6054
Mailing Address - Fax:
Practice Address - Street 1:562 DURAM RD
Practice Address - Street 2:
Practice Address - City:OLIVE BRANCH
Practice Address - State:MS
Practice Address - Zip Code:38654-6819
Practice Address - Country:US
Practice Address - Phone:901-516-6054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-19
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000022034363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily