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General NPI Number Information
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NPI Number | 1639651920
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Entity Type | Individual
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Provider Name | KAREN ELIZABETH CERCONE NP-C
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Gender | Female
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Dates
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Enumeration Date | 09/03/2018
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Last Update Date | 04/15/2024
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Provider Practice Location Address
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Address Line | 701 WALL ST
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City | VALPARAISO
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State | IN
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Zip | 46383
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Country | US
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Telephone | 219-288-8419
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Fax | 219-462-1180
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Provider Business Mailing Address
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Address Line | 1047 CRABTREE LN
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City | CHESTERTON
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State | IN
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Zip | 46304-3128
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Country | US
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Telephone | 219-728-7186
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 28156309A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 28156309
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71008385A
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License Number State | IN
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