Basic Information
Provider Information | |||||||||
NPI: | 1700832896 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | HONKE-KARUN | ||||||||
FirstName: | ALLISON | ||||||||
MiddleName: | ANN | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | KARUN | ||||||||
OtherFirstName: | ALLISON | ||||||||
OtherMiddleName: | ANN | ||||||||
OtherNamePrefix: | DR. | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | MD | ||||||||
OtherLastNameType: | 2 | ||||||||
Mailing Information | |||||||||
Address1: | 235 E STATE ST | ||||||||
Address2: |   | ||||||||
City: | SAINT CROIX FALLS | ||||||||
State: | WI | ||||||||
PostalCode: | 540244117 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7154833221 | ||||||||
FaxNumber: | 7154830507 | ||||||||
Practice Location | |||||||||
Address1: | 5200 FAIRVIEW BLVD | ||||||||
Address2: |   | ||||||||
City: | WYOMING | ||||||||
State: | MN | ||||||||
PostalCode: | 55092 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6519827000 | ||||||||
FaxNumber: | 7154830507 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/26/2006 | ||||||||
LastUpdateDate: | 10/12/2022 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 10/12/2022 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 44126 | WI | Y |   | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |   |
ID Information
ID | Type | State | Issuer | Description | 34948900 | 05 | WI |   | MEDICAID | 75765500 | 05 | MN |   | MEDICAID |