Healthcare Provider Details

I. General information

NPI: 1598950297
Provider Name (Legal Business Name): KAREN BRIAN POLLITT CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2007
Last Update Date: 05/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1809 N LINCOLN ST
GREENSBURG IN
47240-1272
US

IV. Provider business mailing address

1809 N LINCOLN ST
GREENSBURG IN
47240-1272
US

V. Phone/Fax

Practice location:
  • Phone: 812-662-8115
  • Fax: 812-663-2622
Mailing address:
  • Phone: 812-662-8115
  • Fax: 812-663-2622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberNP-09533
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberCOA.09533-NP
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number28070507A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: