Provider Demographics
NPI:1669096137
Name:WATERS, KARLE ANN (APRN)
Entity type:Individual
Prefix:MS
First Name:KARLE
Middle Name:ANN
Last Name:WATERS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KARLE
Other - Middle Name:
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
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:859-578-5651
Mailing Address - Fax:859-331-3456
Practice Address - Street 1:830 THOMAS MORE PKWY
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017-5102
Practice Address - Country:US
Practice Address - Phone:859-578-5651
Practice Address - Fax:859-331-3456
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-01
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3014592363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner