Provider Demographics
NPI:1285674739
Name:BARANOWSKI, KAREN MARY (CNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:MARY
Last Name:BARANOWSKI
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 1:1560 E MAPLE RD
Mailing Address - Street 2:SUITE 400-CREDENTIALING
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-1138
Mailing Address - Country:US
Mailing Address - Phone:248-538-4701
Mailing Address - Fax:248-538-6545
Practice Address - Street 1:31995 NORTHWESTERN HWY
Practice Address - Street 2:WEISBERG CANCER CENTER
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1625
Practice Address - Country:US
Practice Address - Phone:248-538-4701
Practice Address - Fax:248-538-6545
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704118188363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P32180014Medicare PIN