Provider Demographics
NPI:1861824641
Name:FEDERSPIEL, KAREN ANNE (RN-BC, GCNS-BC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ANNE
Last Name:FEDERSPIEL
Suffix:
Gender:F
Credentials:RN-BC, GCNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11100 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1716
Mailing Address - Country:US
Mailing Address - Phone:216-983-1023
Mailing Address - Fax:216-844-5833
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-983-1023
Practice Address - Fax:216-844-5833
Is Sole Proprietor?:No
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.306069-COA1163WP0808X
OHCOA.10495-NS364SG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health