Provider Demographics
NPI:1356507339
Name:TOURTELOT, KAREN ANN (NP)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:ANN
Last Name:TOURTELOT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10294 MAPLEDALE RD
Mailing Address - Street 2:
Mailing Address - City:HOLLAND PATENT
Mailing Address - State:NY
Mailing Address - Zip Code:13354-4719
Mailing Address - Country:US
Mailing Address - Phone:315-865-5127
Mailing Address - Fax:
Practice Address - Street 1:CENTRAL NEW YORK PSYCHIATRIC CENTER
Practice Address - Street 2:RIVER RD
Practice Address - City:MARCY,
Practice Address - State:NY
Practice Address - Zip Code:13403
Practice Address - Country:US
Practice Address - Phone:315-765-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF400872-1163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health