Healthcare Provider Details

I. General information

NPI: 1154246569
Provider Name (Legal Business Name): KAREN REBECCA ERNEST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1902 ANNESLEY RD
EAST LIVERPOOL OH
43920-9128
US

IV. Provider business mailing address

1902 ANNESLEY RD
EAST LIVERPOOL OH
43920-9128
US

V. Phone/Fax

Practice location:
  • Phone: 727-455-0804
  • Fax:
Mailing address:
  • Phone: 727-455-0804
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: