Provider Demographics
NPI:1306199070
Name:SMITH, KAROL IVERA (RN)
Entity Type:Individual
Prefix:
First Name:KAROL
Middle Name:IVERA
Last Name:SMITH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KAROL
Other - Middle Name:IVERA
Other - Last Name:SCHLOSSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:811 SADDLEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:HOLMEN
Mailing Address - State:WI
Mailing Address - Zip Code:54636
Mailing Address - Country:US
Mailing Address - Phone:608-769-1270
Mailing Address - Fax:
Practice Address - Street 1:811 SADDLEWOOD ST
Practice Address - Street 2:
Practice Address - City:HOLMEN
Practice Address - State:WI
Practice Address - Zip Code:54636
Practice Address - Country:US
Practice Address - Phone:608-769-1270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-18
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI56540-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse