Provider Demographics
NPI:1013129626
Name:LANDWEHR, KAREN (APRN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:LANDWEHR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:800-737-7900
Mailing Address - Fax:859-655-2320
Practice Address - Street 1:1360 DOLWICK DR
Practice Address - Street 2:
Practice Address - City:ERLANGER
Practice Address - State:KY
Practice Address - Zip Code:41018-3127
Practice Address - Country:US
Practice Address - Phone:800-737-7900
Practice Address - Fax:859-655-2320
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3005302363L00000X
KY5302P363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2803167Medicaid
KY7100026530Medicaid
KY0690110Medicare PIN
KY3403812Medicare PIN
KY7100026530Medicaid
P00623952Medicare PIN
KY0364984Medicare PIN
KY00182011Medicare PIN