Provider Demographics
NPI:1063929313
Name:JURICA, KAREN RENEE (CNP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:RENEE
Last Name:JURICA
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:RENEE
Other - Last Name:HAMMONDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2427 COTTINGTON ST NW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-5730
Mailing Address - Country:US
Mailing Address - Phone:330-205-1039
Mailing Address - Fax:
Practice Address - Street 1:1825 FRANKS PKWY
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-6249
Practice Address - Country:US
Practice Address - Phone:330-899-5540
Practice Address - Fax:330-899-5543
Is Sole Proprietor?:No
Enumeration Date:2018-01-09
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.021892363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily