Provider Demographics
NPI:1144465055
Name:FORSMAN, KAREN PICKENS (CRNA)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:PICKENS
Last Name:FORSMAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 E 21ST ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-1202
Mailing Address - Country:US
Mailing Address - Phone:843-437-5329
Mailing Address - Fax:
Practice Address - Street 1:10342 E 21ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74129-1606
Practice Address - Country:US
Practice Address - Phone:843-437-5329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-05
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9315694367500000X
OK122656367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG902HOtherBCBS
FL003406000Medicaid
FLG902HOtherBCBS