Provider Demographics
NPI:1396150603
Name:VITKUS, KAREN (MSN, FNP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:VITKUS
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 SIMS DR
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13244-4412
Mailing Address - Country:US
Mailing Address - Phone:315-443-8000
Mailing Address - Fax:855-710-2816
Practice Address - Street 1:150 SIMS DR
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13244-9208
Practice Address - Country:US
Practice Address - Phone:315-443-8000
Practice Address - Fax:855-710-2816
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY338831363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily