Healthcare Provider Details

I. General information

NPI: 1255140018
Provider Name (Legal Business Name): KAREN BOBST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2025
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1222 CHEROKEE DR
SPRINGFIELD OH
45506-3205
US

IV. Provider business mailing address

1222 CHEROKEE DR
SPRINGFIELD OH
45506-3205
US

V. Phone/Fax

Practice location:
  • Phone: 937-561-0115
  • Fax:
Mailing address:
  • Phone: 937-561-0115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: