Provider Demographics
NPI:1316052442
Name:CHEEK, KAREN J (APRN)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:J
Last Name:CHEEK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 GARRARD SQ
Mailing Address - Street 2:PO BOX 57
Mailing Address - City:MANCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40962-5759
Mailing Address - Country:US
Mailing Address - Phone:606-658-6333
Mailing Address - Fax:606-658-2173
Practice Address - Street 1:90 GARRARD SQ
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40962-5759
Practice Address - Country:US
Practice Address - Phone:606-658-6333
Practice Address - Fax:606-658-2173
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3004233363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78012374Medicaid
KYQ21951Medicare UPIN
KY0742706Medicare PIN