Provider Demographics
NPI:1376517227
Name:STICE, KAREN A (ARNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:STICE
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Gender:F
Credentials:ARNP
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Mailing Address - Street 1:4003 KRESGE WAY
Mailing Address - Street 2:STE 312
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207
Mailing Address - Country:US
Mailing Address - Phone:502-899-7377
Mailing Address - Fax:502-899-1972
Practice Address - Street 1:4003 KRESGE WAY
Practice Address - Street 2:STE 312
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207
Practice Address - Country:US
Practice Address - Phone:502-899-7377
Practice Address - Fax:502-899-1972
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2010-02-17
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Provider Licenses
StateLicense IDTaxonomies
KY2579P207RP1001X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
P31567Medicare UPIN
KY0548906Medicare PIN