Provider Demographics
NPI:1710755756
Name:BRACKBILL, KAREN (APRN-CNM)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:BRACKBILL
Suffix:
Gender:F
Credentials:APRN-CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:981 E DUNEDIN RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-3302
Mailing Address - Country:US
Mailing Address - Phone:614-264-8804
Mailing Address - Fax:
Practice Address - Street 1:981 E DUNEDIN RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-3302
Practice Address - Country:US
Practice Address - Phone:614-264-8804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNM.0019585367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife