Provider Demographics
NPI:1548451131
Name:TAYMORE, KAREN KAYE (APN)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:KAYE
Last Name:TAYMORE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 HALSTED CIR
Mailing Address - Street 2:STE 101
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-3185
Mailing Address - Country:US
Mailing Address - Phone:479-633-8220
Mailing Address - Fax:479-340-1088
Practice Address - Street 1:7 HALSTEAD CIR
Practice Address - Street 2:STE 101
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-3185
Practice Address - Country:US
Practice Address - Phone:479-633-8220
Practice Address - Fax:479-340-1088
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARS01091363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health