Provider Demographics
NPI:1598938029
Name:O'HARA, KAREN L (LPN)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:L
Last Name:O'HARA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 WADSWORTH RD
Mailing Address - Street 2:
Mailing Address - City:NORTH SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13212-1234
Mailing Address - Country:US
Mailing Address - Phone:315-458-8836
Mailing Address - Fax:315-458-8836
Practice Address - Street 1:208 WADSWORTH RD
Practice Address - Street 2:
Practice Address - City:NORTH SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13212-1234
Practice Address - Country:US
Practice Address - Phone:315-458-8836
Practice Address - Fax:315-458-8836
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-04
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY163003-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse