Provider Demographics
NPI:1598240616
Name:LOUGH, KAREN L (RN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:L
Last Name:LOUGH
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 5003
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-0003
Mailing Address - Country:US
Mailing Address - Phone:928-853-5337
Mailing Address - Fax:
Practice Address - Street 1:2601 OLD CAMDEN SQ APT 101
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53718-7975
Practice Address - Country:US
Practice Address - Phone:928-853-5337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-25
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI231066163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse