Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 149967 | MO |
NPI | 1013012301 |
---|---|
Provider Name | Mrs. Karen Suzanne Tharp |
First Address | High Ridge, MO 63049-3227 |
Second Address | High Ridge, MO 63049-3227 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2006 |
Last Update Date | 05/12/2007 |