Provider Demographics
NPI:1932201068
Name:ROBERTS, KAREN N (ARNP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:N
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4525 W 6TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-4815
Mailing Address - Country:US
Mailing Address - Phone:785-843-5160
Mailing Address - Fax:785-843-2524
Practice Address - Street 1:4525 W 6TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-4815
Practice Address - Country:US
Practice Address - Phone:785-843-5160
Practice Address - Fax:785-843-2524
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS44944363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSP49388Medicare UPIN
KS160745Medicare ID - Type Unspecified