Provider Demographics
NPI:1306985486
Name:DOWDEN, KAREN MARIE (NP)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:MARIE
Last Name:DOWDEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1214 RICHARDSON ST
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-3549
Mailing Address - Country:US
Mailing Address - Phone:810-982-5200
Mailing Address - Fax:810-982-9776
Practice Address - Street 1:1214 RICHARDSON ST
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-3549
Practice Address - Country:US
Practice Address - Phone:810-982-5200
Practice Address - Fax:810-982-9776
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704255448363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIN52480004Medicare UPIN