Provider Demographics
NPI:1306994488
Name:HOMAN, KAREN M (DIETICIAN)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:HOMAN
Suffix:
Gender:F
Credentials:DIETICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:OH
Mailing Address - Zip Code:45822-2413
Mailing Address - Country:US
Mailing Address - Phone:567-890-7127
Mailing Address - Fax:419-586-1614
Practice Address - Street 1:950 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:OH
Practice Address - Zip Code:45822-2413
Practice Address - Country:US
Practice Address - Phone:567-890-7127
Practice Address - Fax:419-586-1614
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5158133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education