Provider Demographics
NPI:1710016100
Name:DAVID, KAREN SUE (RN)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:SUE
Last Name:DAVID
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 1:2471 HAVERFORD RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-4203
Mailing Address - Country:US
Mailing Address - Phone:614-273-0051
Mailing Address - Fax:614-273-0051
Practice Address - Street 1:2471 HAVERFORD RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-4203
Practice Address - Country:US
Practice Address - Phone:614-273-0051
Practice Address - Fax:614-273-0051
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH177011163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2155680Medicaid