Provider Demographics
NPI:1376898775
Name:STAPLE, KAREN ELIZABETH (FNP)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ELIZABETH
Last Name:STAPLE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:612 CORPORATE WAY
Mailing Address - Street 2:
Mailing Address - City:VALLEY COTTAGE
Mailing Address - State:NY
Mailing Address - Zip Code:10989-2021
Mailing Address - Country:US
Mailing Address - Phone:877-258-6331
Mailing Address - Fax:718-362-1411
Practice Address - Street 1:34 CROMER RD E
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-4825
Practice Address - Country:US
Practice Address - Phone:877-258-6331
Practice Address - Fax:718-362-1651
Is Sole Proprietor?:No
Enumeration Date:2012-07-23
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY444135163W00000X
NYF337464363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00695941Medicaid
NY00695941Medicaid
NYG100000410Medicare Oscar/Certification