Individual
KAREN REECE PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, NP-C
Contact information
Practice address
1550 N BRIDGE ST, ELKIN, NC 28621-2202
(336) 258-2031
(336) 258-2037
Mailing address
114W MEDICAL PARK DR, LEXINGTON, NC 27292-6773
(336) 249-8760
(336) 249-2710
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0024168075
VA
363LF0000X
Family Nurse Practitioner
Primary
102692
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164695227
—
NC
01
—
454639427
TAX ID
NC
01
—
B667
GROUP PTAN
VA
Enumeration date
04/10/2008
Last updated
11/11/2015
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