Provider Demographics
NPI:1922087030
Name:VITALE, KAREN S (RN, CS, ANP)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:S
Last Name:VITALE
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Gender:F
Credentials:RN, CS, ANP
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Mailing Address - Street 1:10777 SUNSET OFFICE DR
Mailing Address - Street 2:SUITE 310
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63127-1019
Mailing Address - Country:US
Mailing Address - Phone:314-822-5900
Mailing Address - Fax:314-822-5919
Practice Address - Street 1:1031 BELLEVUE AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1818
Practice Address - Country:US
Practice Address - Phone:314-644-6300
Practice Address - Fax:314-644-2503
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2008-11-06
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Provider Licenses
StateLicense IDTaxonomies
MO140041363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOS94680Medicare UPIN
MO000080531Medicare PIN