Provider Demographics
NPI:1003808510
Name:KOPLIN, KAREN E (CNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:E
Last Name:KOPLIN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3632 RIDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-3124
Mailing Address - Country:US
Mailing Address - Phone:330-666-6266
Mailing Address - Fax:330-666-6265
Practice Address - Street 1:3632 RIDGEWOOD RD
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-3124
Practice Address - Country:US
Practice Address - Phone:330-666-6266
Practice Address - Fax:330-666-6265
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP05347163W00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2487241Medicaid
OHH287230Medicare PIN
OH2487241Medicaid
OH2487241Medicaid
OHH287230Medicare PIN
OH1841239274OtherPARTNERS PHYSICIAN GROUP TYPE 2 NPI #