Provider Demographics
NPI:1558999748
Name:FOSBRINK, KAREN RENEE (APRN-CNP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:RENEE
Last Name:FOSBRINK
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:944 CHERRY ST E
Mailing Address - Street 2:
Mailing Address - City:CANAL FULTON
Mailing Address - State:OH
Mailing Address - Zip Code:44614-8669
Mailing Address - Country:US
Mailing Address - Phone:330-854-4281
Mailing Address - Fax:
Practice Address - Street 1:860 BROAD ST
Practice Address - Street 2:
Practice Address - City:WADSWORTH
Practice Address - State:OH
Practice Address - Zip Code:44281-9052
Practice Address - Country:US
Practice Address - Phone:330-331-7106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-01
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0027059363LF0000X
VA0001247652163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WS0200XNursing Service ProvidersRegistered NurseSchool