Karen E Nibblett, PMHNP, CNS

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

200450084 NP Issued in OR

Practice address

13007 NE Glisan St
Portland, OR 97230-2545

Phone

(503) 215-5600

Fax

(503) 215-7864

NPI assigned

May 8, 2008

Last updated

Sep 30, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Specialist

State licenses

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

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1720255854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13007 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972302545",
            "telephone_number": "503-215-5600",
            "fax_number": "503-215-7864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13007 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972302545",
            "telephone_number": "503-215-5600",
            "fax_number": "503-215-7864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIBBLETT",
        "first_name": "KAREN",
        "middle_name": "E",
        "credential": "PMHNP, CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-08",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "200450084 NP",
            "primary": true
        },
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "OR",
            "license": "200470021CNS",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "knibblett199758@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "4531 SE Belmont St Ste 100",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972151675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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.