Provider Demographics
NPI:1245873959
Name:ROSS, KAREN (CRNP)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:
Last Name:ROSS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-1212
Mailing Address - Country:US
Mailing Address - Phone:607-432-8500
Mailing Address - Fax:
Practice Address - Street 1:330 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-1212
Practice Address - Country:US
Practice Address - Phone:410-334-2227
Practice Address - Fax:607-431-9027
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-25
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR166689363LA2200X
NY311485363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health