Provider Demographics
NPI:1275624173
Name:LOGEMAN, KAREN M (CNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:LOGEMAN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1450 COLUMBUS AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WASHINGTON COURT HOUSE
Mailing Address - State:OH
Mailing Address - Zip Code:43160-3701
Mailing Address - Country:US
Mailing Address - Phone:740-333-2234
Mailing Address - Fax:740-333-3881
Practice Address - Street 1:1510 COLUMBUS AVE
Practice Address - Street 2:SUITE 230
Practice Address - City:WASHINGTON COURT HOUSE
Practice Address - State:OH
Practice Address - Zip Code:43160-1899
Practice Address - Country:US
Practice Address - Phone:740-333-3333
Practice Address - Fax:740-333-5171
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHRN172912163W00000X
OHNP05564363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2157160Medicaid
OHQ56620Medicare UPIN
OHNP19651Medicare PIN
OHH117800Medicare PIN