Healthcare Provider Details

I. General information

NPI: 1346648854
Provider Name (Legal Business Name): KAREN NICOLE MCCLOSKEY CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN NICOLE MCCLOSKEY MSN, RN, ACCNS-AG

II. Dates (important events)

Enumeration Date: 12/16/2014
Last Update Date: 01/02/2023
Certification Date: 01/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 JASONWAY AVE STE B
COLUMBUS OH
43214-2456
US

IV. Provider business mailing address

921 JASONWAY AVE STE B
COLUMBUS OH
43214-2456
US

V. Phone/Fax

Practice location:
  • Phone: 614-330-5980
  • Fax:
Mailing address:
  • Phone: 614-268-8800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number338552
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License Number019406
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberAPRN.CNS.019406
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: