Individual
KAREN MICHELLE BRANCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2210 W MAIN ST, RUSSELLVILLE, AR 72801-2760
(479) 968-8940
(479) 968-8901
Mailing address
P O BOX 1848, MENA, AR 71953-1841
(479) 437-3449
(479) 437-3708
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A003317
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
187259758
—
AR
01
—
710808809
TAX ID
AR
Enumeration date
09/28/2009
Last updated
11/25/2020
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