Provider Demographics
NPI:1851993745
Name:HANNES, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:HANNES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 WILDER AVE
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-3022
Mailing Address - Country:US
Mailing Address - Phone:216-299-1402
Mailing Address - Fax:
Practice Address - Street 1:908 WILDER AVE
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-3022
Practice Address - Country:US
Practice Address - Phone:216-299-1402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-15
Last Update Date:2020-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4705891OtherOHIO DEPT OF DISABILITIES