Provider Demographics
NPI:1811990609
Name:JAMES, KAREN C (ANP)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:C
Last Name:JAMES
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3245 HEALTH DR STE 100
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-1380
Mailing Address - Country:US
Mailing Address - Phone:574-647-2129
Mailing Address - Fax:
Practice Address - Street 1:206 W WARREN ST
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:IN
Practice Address - Zip Code:46540-9410
Practice Address - Country:US
Practice Address - Phone:574-358-0042
Practice Address - Fax:574-358-0157
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001860A363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200505360Medicaid
IN000000598095OtherBCBS MEDPOINTS
IN000000387971OtherANTHEM BCBS #
INP00933703OtherRR MEDICARE
IN000000680723OtherBCBS MEMORIAL BARIATRIC SURGERY
INQ35393Medicare UPIN
IN000000598095OtherBCBS MEDPOINTS
IN000000680723OtherBCBS MEMORIAL BARIATRIC SURGERY
IN231400C5Medicare PIN