Healthcare Provider Details

I. General information

NPI: 1285863910
Provider Name (Legal Business Name): KAREN LYNN MCSTAY R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2009
Last Update Date: 07/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 VIRGINIA DR
HUDSON OH
44236-3776
US

IV. Provider business mailing address

845 VIRGINIA DR
HUDSON OH
44236-3776
US

V. Phone/Fax

Practice location:
  • Phone: 330-650-1603
  • Fax:
Mailing address:
  • Phone: 330-650-1603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN289666
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: