Individual
MRS. KAREN T CLUBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3708 NORTHSIDE DR, MACON, GA 31210-2404
(478) 745-4206
(478) 254-5463
Mailing address
3708 NORTHSIDE DR, MACON, GA 31210-2404
(478) 745-4206
(478) 254-5463
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN077688
GA
363LF0000X
Family Nurse Practitioner
Primary
RN077688
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN077688
GEORGIA LICENSE
GA
Enumeration date
01/16/2009
Last updated
10/15/2025
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