Provider Demographics
NPI:1538281761
Name:HAESLOOP, KAREN F (FNP)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:F
Last Name:HAESLOOP
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 RICHARD PL
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-3131
Mailing Address - Country:US
Mailing Address - Phone:607-272-1577
Mailing Address - Fax:
Practice Address - Street 1:430 RICHARD PL
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-3131
Practice Address - Country:US
Practice Address - Phone:607-272-1577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY329054163WG0000X
NY335298363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice