Provider Demographics
NPI:1699103366
Name:PYNE, KARLENE
Entity type:Individual
Prefix:
First Name:KARLENE
Middle Name:
Last Name:PYNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KARLENE
Other - Middle Name:P
Other - Last Name:PYNE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:375 W 500 S
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-4809
Mailing Address - Country:US
Mailing Address - Phone:801-224-4731
Mailing Address - Fax:
Practice Address - Street 1:1034 N 500 W
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-3380
Practice Address - Country:US
Practice Address - Phone:801-357-7850
Practice Address - Fax:801-357-7958
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-16
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT192877-3102163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse