Provider Demographics
NPI:1346648854
Name:MCCLOSKEY, KAREN NICOLE (CNS)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:NICOLE
Last Name:MCCLOSKEY
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:NICOLE
Other - Last Name:MCCLOSKEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSN, RN, ACCNS-AG
Mailing Address - Street 1:921 JASONWAY AVE STE B
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-2456
Mailing Address - Country:US
Mailing Address - Phone:614-268-8800
Mailing Address - Fax:
Practice Address - Street 1:921 JASONWAY AVE STE B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-2456
Practice Address - Country:US
Practice Address - Phone:614-330-5980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-16
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH338552163W00000X
OH019406364SA2100X
OHAPRN.CNS.019406364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No163W00000XNursing Service ProvidersRegistered Nurse
No364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0369241Medicaid