Provider Demographics
NPI:1003136300
Name:DOLL, KAREN D (ANP, CVNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:D
Last Name:DOLL
Suffix:
Gender:F
Credentials:ANP, CVNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MEDICAL UNIVERSITY OF SOUTH CAROLINA
Mailing Address - Street 2:114 DOUGHTY STREET SUITE 654
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29424-0001
Mailing Address - Country:US
Mailing Address - Phone:843-876-4854
Mailing Address - Fax:843-876-4413
Practice Address - Street 1:MEDICAL UNIVERSITY OF SOUTH CAROLINA
Practice Address - Street 2:114 DOUGHTY STREET SUITE 654
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29424-0001
Practice Address - Country:US
Practice Address - Phone:843-876-4854
Practice Address - Fax:843-876-4413
Is Sole Proprietor?:No
Enumeration Date:2010-06-09
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY305390363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03743675Medicaid