Provider Demographics
NPI:1154825420
Name:NITZEL, KAREN GENE (LPN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:GENE
Last Name:NITZEL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8177 CLEVE MASS RD LOT 30
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:OH
Mailing Address - Zip Code:44216-9146
Mailing Address - Country:US
Mailing Address - Phone:330-573-8606
Mailing Address - Fax:
Practice Address - Street 1:8177 CLEVE MASS RD LOT 30
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:OH
Practice Address - Zip Code:44216-9146
Practice Address - Country:US
Practice Address - Phone:330-573-8606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-21
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN044935MIV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty