Karen Distelhorst, GCNS-BC

Primary specialty

Gerontology Clinical Nurse SpecialistTaxonomy code 364SG0600X

License

RN21200763 COA02806 Issued in OH

Practice address

650 Graham Rd
Cuyahoga Falls, OH 44221-1052

Phone

(330) 590-0847

NPI assigned

Mar 29, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301356800000",
    "number": "1326337403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3129 DUNSTONE AVE",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443125918",
            "telephone_number": "330-645-0641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 GRAHAM RD",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442211052",
            "telephone_number": "330-590-0847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISTELHORST",
        "first_name": "KAREN",
        "credential": "GCNS-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-29",
        "last_updated": "2011-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "OH",
            "license": "RN21200763 COA02806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gerontology Clinical Nurse Specialist in Cuyahoga Falls, OH
• Providers in Cuyahoga Falls, OH by specialty
• Gerontology Clinical Nurse Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.