Healthcare Provider Details

I. General information

NPI: 1639250665
Provider Name (Legal Business Name): KAREN JEANNINE DUBOIS HEUSEL PH.D., RN, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 PLAZA DR
SAINT CLAIRSVILLE OH
43950-8786
US

IV. Provider business mailing address

851 BUENA VISTA BLVD
STEUBENVILLE OH
43952-1026
US

V. Phone/Fax

Practice location:
  • Phone: 740-695-9321
  • Fax:
Mailing address:
  • Phone: 740-264-6504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP-08122
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: