Provider Demographics
NPI:1942475215
Name:MUNDY, KAREN E (NP-C)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:E
Last Name:MUNDY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:831 NASHVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-3103
Mailing Address - Country:US
Mailing Address - Phone:615-206-0500
Mailing Address - Fax:
Practice Address - Street 1:353 NEW SHACKLE ISLAND RD
Practice Address - Street 2:SUITE 141-C
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-2379
Practice Address - Country:US
Practice Address - Phone:615-826-3100
Practice Address - Fax:615-447-1060
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN13328363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNRN69973OtherREGISTERED NURSE LICENSE
TNAPN13328OtherNURSE PRACTITIONER LICENSE