Provider Demographics
NPI:1538411384
Name:COLBURN, KAREN (RN)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:COLBURN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 WEBSTER AVE
Mailing Address - Street 2:1 FLOOR
Mailing Address - City:HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10528-2929
Mailing Address - Country:US
Mailing Address - Phone:914-341-1440
Mailing Address - Fax:
Practice Address - Street 1:111 WEBSTER AVE
Practice Address - Street 2:1 FLOOR
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528-2929
Practice Address - Country:US
Practice Address - Phone:914-341-1440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-03
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY661532163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse