Provider Demographics
NPI:1538594494
Name:DAINGERFIELD, KAREN DENISE (FNP)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:DENISE
Last Name:DAINGERFIELD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 OLD SMITHVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37110-5934
Mailing Address - Country:US
Mailing Address - Phone:931-259-4144
Mailing Address - Fax:931-259-4143
Practice Address - Street 1:931 OLD SMITHVILLE RD
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110-5934
Practice Address - Country:US
Practice Address - Phone:931-259-4144
Practice Address - Fax:931-259-4143
Is Sole Proprietor?:No
Enumeration Date:2013-09-11
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17942363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ002283Medicaid