Provider Demographics
NPI:1326677402
Name:FLORENCE, KAREN (C-CHW)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:FLORENCE
Suffix:
Gender:F
Credentials:C-CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12200 FAIRHILL ROAD
Mailing Address - Street 2:C-349
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120
Mailing Address - Country:US
Mailing Address - Phone:216-336-5001
Mailing Address - Fax:
Practice Address - Street 1:12200 FAIRHILL ROAD
Practice Address - Street 2:C-349
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120
Practice Address - Country:US
Practice Address - Phone:216-336-5001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-02
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH001182172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker