Provider Demographics
NPI:1174308951
Name:TRUKOVICH, KAREN LYNN
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LYNN
Last Name:TRUKOVICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6643 MCMULLEN ALLEN RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44444-9252
Mailing Address - Country:US
Mailing Address - Phone:330-872-1926
Mailing Address - Fax:
Practice Address - Street 1:4368 FISHCREEK RD
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-2808
Practice Address - Country:US
Practice Address - Phone:330-673-8238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
376J00000X
OH376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker