Basic Information
| Provider Information | |||||||||
| NPI: | 1376598409 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARNES-ELLIS | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | |||||||||
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| Credential: | APN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 315 MULBERRY ST | ||||||||
| Address2: | |||||||||
| City: | EVANSVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 477131252 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8124217489 | ||||||||
| FaxNumber: | 8124360209 | ||||||||
| Practice Location | |||||||||
| Address1: | 25 W DIVISION ST | ||||||||
| Address2: | |||||||||
| City: | EVANSVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 477101374 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8124364501 | ||||||||
| FaxNumber: | 8124364510 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2006 | ||||||||
| LastUpdateDate: | 01/05/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | 71000074A | IN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 000000488313 | 01 | IN | ANTHEM PIN | OTHER | 200079040D | 01 | IN | MEDICAID GROUP | OTHER | 237890 | 01 | IN | MEDICARE GROUP | OTHER | 000000864712 | 01 | IN | BCBS | OTHER | 65945420 | 01 | KY | MEDICAID GROUP | OTHER | 200512220 | 05 | IN | MEDICAID | 200829650D | 01 | IN | MEDICAID GROUP | OTHER |