Provider Demographics
NPI:1902188527
Name:GREYNOLDS, KAREN D (LPN)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:D
Last Name:GREYNOLDS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5426 WHETSEL AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-1730
Mailing Address - Country:US
Mailing Address - Phone:513-372-0626
Mailing Address - Fax:513-782-4374
Practice Address - Street 1:5426 WHETSEL AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-1730
Practice Address - Country:US
Practice Address - Phone:513-372-0626
Practice Address - Fax:513-782-4374
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-10
Last Update Date:2011-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN-125674-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse