Provider Demographics
NPI:1942635396
Name:SMITH, KAREN J (FNP)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:J
Last Name:SMITH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 SCIOTO ST STE 4
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:OH
Mailing Address - Zip Code:43078-2251
Mailing Address - Country:US
Mailing Address - Phone:937-653-4666
Mailing Address - Fax:937-653-3469
Practice Address - Street 1:900 SCIOTO ST STE 4
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:OH
Practice Address - Zip Code:43078-2251
Practice Address - Country:US
Practice Address - Phone:937-653-4666
Practice Address - Fax:937-653-3469
Is Sole Proprietor?:No
Enumeration Date:2013-09-04
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-RN-LIC-70254363LF0000X
OHCOA18281NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily