| Karen Clum Aprn Llc | |
|
15 Bishop Dr Ste 204 Westerville OH 43081-2276 | |
| (614) 392-5933 | |
| (949) 404-6647 |
| Full Name | Karen Clum Aprn Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 15 Bishop Dr Ste 204, Westerville, Ohio |
| Authorized Official Name and Position | Karen Clum (OWNER) |
| Authorized Official Contact | 6143925933 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Karen Clum Aprn Llc 15 Bishop Dr Ste 204 Westerville OH 43081-2276 Ph: (614) 392-5933 | Karen Clum Aprn Llc 15 Bishop Dr Ste 204 Westerville OH 43081-2276 Ph: (614) 392-5933 |
| NPI Number | 1720641954 |
|---|---|
| Provider Enumeration Date | 04/14/2019 |
| Last Update Date | 03/23/2022 |
| Certification Date | 03/23/2022 |
| Medicare PECOS PAC ID | 5395072201 |
|---|---|
| Medicare Enrollment ID | O20190814002725 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720641954 | NPI | - | NPPES |
| 0123278 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Karen Clum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538576244 PECOS PAC ID: 6608169016 Enrollment ID: I20160722001128 |
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