Provider Demographics
NPI:1508434010
Name:KAPTUR, KAREN ANN (RN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ANN
Last Name:KAPTUR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 252593
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48325-2593
Mailing Address - Country:US
Mailing Address - Phone:313-550-9456
Mailing Address - Fax:248-928-0468
Practice Address - Street 1:4112 AUTUMN RIDGE DR
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48323-2706
Practice Address - Country:US
Practice Address - Phone:313-550-9456
Practice Address - Fax:248-928-0468
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-12
Last Update Date:2021-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704152329163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management