Provider Demographics
NPI:1144464082
Name:BOONE, KAREN A (RN, MS, PMHCNS)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:A
Last Name:BOONE
Suffix:
Gender:F
Credentials:RN, MS, PMHCNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:521 4TH ST
Mailing Address - Street 2:
Mailing Address - City:HAVRE
Mailing Address - State:MT
Mailing Address - Zip Code:59501-3649
Mailing Address - Country:US
Mailing Address - Phone:406-395-4305
Mailing Address - Fax:406-395-5643
Practice Address - Street 1:521 4TH ST
Practice Address - Street 2:
Practice Address - City:HAVRE
Practice Address - State:MT
Practice Address - Zip Code:59501-3649
Practice Address - Country:US
Practice Address - Phone:406-395-4305
Practice Address - Fax:406-395-5997
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-22
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.006636364SP0809X
MT99997364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult