Provider Demographics
NPI:1053167973
Name:KNUDSEN, KAREN MARIE (FNP - C)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:MARIE
Last Name:KNUDSEN
Suffix:
Gender:F
Credentials:FNP - C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 N WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:VIBORG
Mailing Address - State:SD
Mailing Address - Zip Code:57070-2019
Mailing Address - Country:US
Mailing Address - Phone:605-254-2233
Mailing Address - Fax:
Practice Address - Street 1:1010 E 2ND ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:SD
Practice Address - Zip Code:57013-1905
Practice Address - Country:US
Practice Address - Phone:605-987-5659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP003169363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily