Provider Demographics
NPI:1699823492
Name:LOTHAMER, KAREN S (RN, CNS)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:S
Last Name:LOTHAMER
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Gender:
Credentials:RN, CNS
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Mailing Address - Street 1:11109 PARKVIEW PLAZA DR # 117
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46845-1701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2710 LAKE AVE
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46805-5412
Practice Address - Country:US
Practice Address - Phone:260-481-2700
Practice Address - Fax:260-969-8448
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2025-03-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN70000193A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner