Provider Demographics
NPI:1053632489
Name:O'SHEA, KAREN A (RN ANP)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:A
Last Name:O'SHEA
Suffix:
Gender:F
Credentials:RN ANP
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:A
Other - Last Name:STULPIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:BOX 278980
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-784-7854
Mailing Address - Fax:
Practice Address - Street 1:2400 S CLINTON AVE
Practice Address - Street 2:BUILDING H, SUITE 210
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2668
Practice Address - Country:US
Practice Address - Phone:585-341-7299
Practice Address - Fax:585-341-4262
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY305408363LA2200X
NYF305408-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400030761OtherMEDICARE PTAN STRONG ED
NY03238415Medicaid
NYJ400030762OtherMEDICARE PTAN STRONG OBS
NY03238415Medicaid