Provider Demographics
NPI:1043603558
Name:DRISKILL, KAREN (NP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:DRISKILL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41850 W 11 MILE RD STE 207A
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-1820
Mailing Address - Country:US
Mailing Address - Phone:248-860-4634
Mailing Address - Fax:
Practice Address - Street 1:41850 W 11 MILE RD STE 207A
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-1820
Practice Address - Country:US
Practice Address - Phone:248-860-4634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-08
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704257272363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner