Basic Information
| Provider Information | |||||||||
| NPI: | 1821212135 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HULSHIZER | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | L | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 11263 | ||||||||
| Address2: | |||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374012263 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4237783274 | ||||||||
| FaxNumber: | 4237782255 | ||||||||
| Practice Location | |||||||||
| Address1: | 1200 DODSON AVE | ||||||||
| Address2: | |||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374063214 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4237782800 | ||||||||
| FaxNumber: | 4237782806 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/11/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 124Q00000X | 3295 | TN | Y | Dental Providers | Dental Hygienist |
No ID Information.