Provider Demographics
NPI:1194704460
Name:KARNES, KATHRYN LEANN (PT)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:LEANN
Last Name:KARNES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 S GUTENSOHN RD
Mailing Address - Street 2:STE 10
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-5117
Mailing Address - Country:US
Mailing Address - Phone:479-751-7122
Mailing Address - Fax:479-751-7292
Practice Address - Street 1:2793 E MILLENNIUM PL
Practice Address - Street 2:STE 2
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-6508
Practice Address - Country:US
Practice Address - Phone:479-521-2232
Practice Address - Fax:479-521-0513
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT 2860225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR046548AMedicare ID - Type Unspecified
AR5Y735Medicare UPIN