Provider Demographics
NPI:1780916312
Name:SAMUELSON, KAREN LYNN I (RN)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:LYNN
Last Name:SAMUELSON
Suffix:I
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 KATHERINE AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-3841
Mailing Address - Country:US
Mailing Address - Phone:419-207-8192
Mailing Address - Fax:
Practice Address - Street 1:513 KATHERINE AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-3841
Practice Address - Country:US
Practice Address - Phone:419-207-8192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-07
Last Update Date:2010-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH182146163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse