Provider Demographics
NPI:1811617947
Name:DOVE, KAREN LYNN (RPH)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LYNN
Last Name:DOVE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 930
Mailing Address - Street 2:
Mailing Address - City:SEELEY LAKE
Mailing Address - State:MT
Mailing Address - Zip Code:59868-0930
Mailing Address - Country:US
Mailing Address - Phone:406-677-8989
Mailing Address - Fax:406-677-8080
Practice Address - Street 1:3027 MT HIGHWAY 83 N
Practice Address - Street 2:
Practice Address - City:SEELEY LAKE
Practice Address - State:MT
Practice Address - Zip Code:59868-8628
Practice Address - Country:US
Practice Address - Phone:406-677-8989
Practice Address - Fax:406-677-8080
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTPHA-PHA-LIC-5820183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty