Provider Demographics
NPI:1164935953
Name:MOORE, KAREN MCKENNA (CRNP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:MCKENNA
Last Name:MOORE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 23RD AVE N STE 350
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1650
Mailing Address - Country:US
Mailing Address - Phone:615-277-2300
Mailing Address - Fax:615-320-1849
Practice Address - Street 1:330 23RD AVE N STE 350
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1650
Practice Address - Country:US
Practice Address - Phone:615-277-2300
Practice Address - Fax:615-320-1849
Is Sole Proprietor?:No
Enumeration Date:2017-11-15
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN23420363LA2100X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care