Provider Demographics
NPI:1104121714
Name:HARPER, KAREN BLISS (NP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:BLISS
Last Name:HARPER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1228 VAN PORTFLIET AVE NW
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49534-2285
Mailing Address - Country:US
Mailing Address - Phone:616-453-4049
Mailing Address - Fax:
Practice Address - Street 1:3230 EAGLE PARK DR NE STE 200
Practice Address - Street 2:HEARTLAND HOSPICE #4624
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-7047
Practice Address - Country:US
Practice Address - Phone:616-956-0636
Practice Address - Fax:616-956-7617
Is Sole Proprietor?:No
Enumeration Date:2011-01-13
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704159166363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner