Healthcare Provider Details

I. General information

NPI: 1942445705
Provider Name (Legal Business Name): KAREN ANN OLDEN APRN, FNP, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2008
Last Update Date: 12/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 OVERLOOK RD MAC L05
SUMMIT NJ
07901-3570
US

IV. Provider business mailing address

33 OVERLOOK RD MAC L05
SUMMIT NJ
07901-3570
US

V. Phone/Fax

Practice location:
  • Phone: 908-522-2570
  • Fax: 908-522-5628
Mailing address:
  • Phone: 908-522-2570
  • Fax: 908-522-5628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NN08101500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: