Individual
MS. KAREN LOUISE MALLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
30 MON HEALTH DRIVE, MORGANTOWN, WV 26505-2853
(337) 991-9276
(337) 943-0846
Mailing address
1509 DULLES DR, LAFAYETTE, LA 70506-3718
(337) 991-9276
(337) 943-0846
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0024174910
VA
363L00000X
Nurse Practitioner
Primary
APRN99622
WV
363LA2200X
Adult Health Nurse Practitioner
NP 01828
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000553547
ANTHEM
OH
05
—
1396786034
—
WV
05
—
2321722
—
OH
01
—
341847368040
CARESOURCE
OH
Enumeration date
06/10/2006
Last updated
03/07/2023
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