Provider Demographics
NPI:1316031180
Name:HARBAL, KAREN J (CRNA)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:J
Last Name:HARBAL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3003 CIVIC CIRCLE BLVD
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IL
Mailing Address - Zip Code:62959-5259
Mailing Address - Country:US
Mailing Address - Phone:618-993-1112
Mailing Address - Fax:618-993-1113
Practice Address - Street 1:3003 CIVIC CIRCLE BLVD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959-5259
Practice Address - Country:US
Practice Address - Phone:618-993-1112
Practice Address - Fax:618-993-1113
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3703A367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY74004615Medicaid
000000361139OtherBCBS
P00278280OtherRAILROAD MEDICARE
000000361139OtherBCBS
P00278280OtherRAILROAD MEDICARE