Provider Demographics
NPI:1821136698
Name:DONKLE, KAREN L (NP)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:L
Last Name:DONKLE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:LEE
Other - Last Name:CUPELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:215 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS ANIMAS
Mailing Address - State:CO
Mailing Address - Zip Code:81054-1029
Mailing Address - Country:US
Mailing Address - Phone:719-456-6000
Mailing Address - Fax:719-456-9701
Practice Address - Street 1:215 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:LAS ANIMAS
Practice Address - State:CO
Practice Address - Zip Code:81054-1029
Practice Address - Country:US
Practice Address - Phone:719-456-6000
Practice Address - Fax:719-456-9701
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42935363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO42935OtherLICENSE #
CO14958732Medicaid
CO14958732Medicaid
CO42935OtherLICENSE #
COQ53482Medicare UPIN