Provider Demographics
NPI:1598784530
Name:LAHR, KAREN W (CNS)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:W
Last Name:LAHR
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10330 N MERIDIAN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46290-1024
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1907 W SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46901-5148
Practice Address - Country:US
Practice Address - Phone:765-456-5900
Practice Address - Fax:765-456-5815
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71003165A364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001853672OtherMSBCBS
KY30610026Medicaid
610661987OtherCORPHEALTH
000000358162OtherANTHEM BCBS
1228898OtherCHA
0519813Medicare PIN
000000358162OtherANTHEM BCBS
0519912Medicare PIN
0519713Medicare PIN
0519514Medicare PIN