Provider Demographics
NPI:1184657652
Name:MULHOLLAND, KAREN A (APRN-AOCNS)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:MULHOLLAND
Suffix:
Gender:F
Credentials:APRN-AOCNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2701
Mailing Address - Country:US
Mailing Address - Phone:859-258-6520
Mailing Address - Fax:859-258-6539
Practice Address - Street 1:1221 S BROADWAY
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-2701
Practice Address - Country:US
Practice Address - Phone:859-258-6520
Practice Address - Fax:859-258-6539
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3004773364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78017837Medicaid
P00295105OtherRR MEDICARE PIN
KY78017837Medicaid
CB5773OtherRR MEDICARE GROUP
KY37903705OtherMEDICAID LAB GROUP
KY0626737Medicare PIN
KY0169Medicare PIN
KY4000501OtherMEDICARE LAB GROUP