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General NPI Number Information
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NPI Number | 1609485424
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Entity Type | Organization
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Legal Business Name | INTENSIVE KAREN LLC
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Dates
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Enumeration Date | 07/28/2020
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Last Update Date | 07/28/2020
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Provider Practice Location Address
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Address Line | 612 MULFORD ST APT 503
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City | EVANSTON
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State | IL
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Zip | 60202-3531
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Country | US
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Telephone | 847-636-1607
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Fax |
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Provider Business Mailing Address
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Address Line | 612 MULFORD ST APT 503
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City | EVANSTON
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State | IL
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Zip | 60202-3531
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Country | US
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Telephone | 847-636-1607
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | KAREN L. KOPAN
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Credential | DNP, APRN, ACNP-BC
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Telephone | 847-636-1607
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number |
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License Number State |
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