Provider Demographics
NPI:1811929748
Name:KAROLYI, CAROLYN JEAN (C-NP)
Entity type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:JEAN
Last Name:KAROLYI
Suffix:
Gender:M
Credentials:C-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2473 STATE ROUTE 725
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:OH
Mailing Address - Zip Code:45370-8741
Mailing Address - Country:US
Mailing Address - Phone:937-475-3105
Mailing Address - Fax:
Practice Address - Street 1:324 WILMINGTON AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45420-1890
Practice Address - Country:US
Practice Address - Phone:937-203-9228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2013-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-142445363L00000X
OHNP04951363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0050116Medicaid
OH0050116Medicaid