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Individual

DR. DANA KAREN NORTHERN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1405 NASHVILLE ST, RUSSELLVILLE, KY 42276-8850
(270) 725-9606
(270) 725-9643
Mailing address
PO BOX 729, RUSSELLVILLE, KY 42276-0729
(270) 725-9606
(270) 725-9643

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
KY21468
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000068666
KENTUCKY BLUE CROSS
KY
05
64214687
KY
Enumeration date
07/01/2005
Last updated
10/29/2007
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