Provider Demographics
NPI:1932546553
Name:PAGE, KAREN SUE (LPN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:SUE
Last Name:PAGE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2897 SHARPSVILLE RD
Mailing Address - Street 2:PO BOX 71
Mailing Address - City:LYNCHBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45142-9410
Mailing Address - Country:US
Mailing Address - Phone:513-439-4241
Mailing Address - Fax:
Practice Address - Street 1:2897 SHARPSVILLE RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:OH
Practice Address - Zip Code:45142-9410
Practice Address - Country:US
Practice Address - Phone:513-439-4241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-23
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN092070164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRG234324OtherDRIVERS LICENSE