Provider Demographics
NPI:1942442272
Name:PHILLIPS, KAREN N
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:N
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 N WALTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-4576
Mailing Address - Country:US
Mailing Address - Phone:479-271-6302
Mailing Address - Fax:479-271-6307
Practice Address - Street 1:ONE LAUBACH DRIVE
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-0000
Practice Address - Country:US
Practice Address - Phone:870-240-0671
Practice Address - Fax:870-240-0514
Is Sole Proprietor?:No
Enumeration Date:2009-04-01
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator