Provider Demographics
NPI:1003079328
Name:PAULEY, KAREN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:
Last Name:PAULEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22100 STATE ROUTE 245
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-8005
Mailing Address - Country:US
Mailing Address - Phone:937-642-6274
Mailing Address - Fax:
Practice Address - Street 1:402 S STATE ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-5000
Practice Address - Country:US
Practice Address - Phone:740-387-4115
Practice Address - Fax:740-387-9210
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50000436363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical