Provider Demographics
NPI:1801908835
Name:KARENBAUER, HEATHER
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:KARENBAUER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1424 W MAIN ST STE 3
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16127-1067
Mailing Address - Country:US
Mailing Address - Phone:724-458-7737
Mailing Address - Fax:724-458-7388
Practice Address - Street 1:1424 W MAIN ST STE 3
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:PA
Practice Address - Zip Code:16127-1067
Practice Address - Country:US
Practice Address - Phone:724-458-7737
Practice Address - Fax:724-458-7388
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP007832363LW0102X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASP007832OtherPA WHNP
PASP007850OtherPA ANP
MI4704234443OtherSTATE LICENSE
PARN356660LOtherPA RN
PASP011649OtherPA FNP
PASP011649OtherPA FNP
PASP007850OtherPA ANP