Karen Rose
Individual provider Active NPI Gerontology Nurse Practitioner · Park Hills, MO
NPI 1760930465 · NPPES record last updated Apr 23, 2024
Key facts
- NPI
- 1760930465
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gerontology Nurse Practitioner 363LG0600X
- License
- 2016010708 (MO)
- Practice address
- 5272 Flat River Dr
Park Hills, MO 63601-2224 - Phone
- (773) 431-0162
- NPI assigned
- Sep 12, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2016010708 | MO | MD | Gerontology Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 2016010708 | MO | Yes |
Addresses
Primary practice location
5272 Flat River Dr
Park Hills, MO 63601-2224
Mailing address
6565 Bobwhite LN
French Village, MO 63036-1433
Phone (618) 340-2177
Other providers in Park Hills, MO
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- Lee Ann Roberts
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- Deborah L Sherrill
- Matthew David Sherrill
All providers in Park Hills, MO · Gerontology Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.