Provider Demographics
NPI:1992805113
Name:SMITH, KAREN SUE (ARNP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:SUE
Last Name:SMITH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:SUE
Other - Last Name:HIGGINS/BORDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:1100 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67501-4406
Mailing Address - Country:US
Mailing Address - Phone:620-669-6690
Mailing Address - Fax:620-669-6763
Practice Address - Street 1:1100 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67501-4406
Practice Address - Country:US
Practice Address - Phone:620-669-6690
Practice Address - Fax:620-669-6763
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45418363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100451100AMedicaid
KS100451100BMedicaid
KS161054Medicare PIN
160916Medicare ID - Type Unspecified
KS100451100AMedicaid