Provider Demographics
NPI:1093982944
Name:HUMMEL, KAREN S (MSN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:S
Last Name:HUMMEL
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 W MUSKEGON DR
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46140-3069
Mailing Address - Country:US
Mailing Address - Phone:317-468-4357
Mailing Address - Fax:317-468-4580
Practice Address - Street 1:124 W MUSKEGON DR
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140-3069
Practice Address - Country:US
Practice Address - Phone:317-468-4357
Practice Address - Fax:317-468-4580
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000188A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
12489044OtherCAQH