Provider Demographics
NPI:1770084170
Name:MASSIE, KAREN MARIE (NURSE LVN)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:MARIE
Last Name:MASSIE
Suffix:
Gender:F
Credentials:NURSE LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:571 COUNTY ROAD 15900
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75462-4212
Mailing Address - Country:US
Mailing Address - Phone:903-272-2983
Mailing Address - Fax:
Practice Address - Street 1:571 COUNTY ROAD 15900
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75462-4212
Practice Address - Country:US
Practice Address - Phone:903-272-2983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-22
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX307548164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse