Provider Demographics
NPI:1700096773
Name:SPROUL, KAREN A (FNP - C, ANP-C)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:A
Last Name:SPROUL
Suffix:
Gender:F
Credentials:FNP - C, ANP-C
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Mailing Address - Street 1:111 PENINSULA DR
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON
Mailing Address - State:NY
Mailing Address - Zip Code:11777-1110
Mailing Address - Country:US
Mailing Address - Phone:631-642-1733
Mailing Address - Fax:631-642-1733
Practice Address - Street 1:STONYBROOK UNIVERSITY HOSPITAL
Practice Address - Street 2:DEPT. OF EMERGENCY MEDICINE - HSC LEVEL 4 - ROOM 080
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8350
Practice Address - Country:US
Practice Address - Phone:631-444-2478
Practice Address - Fax:631-444-3919
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF335149-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily