Provider Demographics
NPI:1265547749
Name:POCILUYKO, KAREN J (RNC, NP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:J
Last Name:POCILUYKO
Suffix:
Gender:F
Credentials:RNC, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 N HINTZ RD
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-9019
Mailing Address - Country:US
Mailing Address - Phone:989-723-6420
Mailing Address - Fax:989-723-6420
Practice Address - Street 1:205 N HINTZ RD
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-9019
Practice Address - Country:US
Practice Address - Phone:989-723-6420
Practice Address - Fax:989-723-6420
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704170764363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology