Basic Information
| Provider Information | |||||||||
| NPI: | 1760459655 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SEIDNER | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | CRNA | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SEIDNER | ||||||||
| OtherFirstName: | KAREN | ||||||||
| OtherMiddleName: | L | ||||||||
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| OtherCredential: | CRNA | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1299 OLENTANGY RIVER RD | ||||||||
| Address2: | STE 103 | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 43212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6145664278 | ||||||||
| FaxNumber: | 6145665424 | ||||||||
| Practice Location | |||||||||
| Address1: | 111 S GRANT AVE | ||||||||
| Address2: | 3RD FL | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 43215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6145668808 | ||||||||
| FaxNumber: | 6145669503 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/01/2006 | ||||||||
| LastUpdateDate: | 06/12/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | RN128848 | OH | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 367500000X | NA03638 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 367500000X | RN536272 | PA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.