Provider Demographics
NPI:1487621124
Name:CIMILLUCA, KAREN SCOTT (CRNA)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:SCOTT
Last Name:CIMILLUCA
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Gender:F
Credentials:CRNA
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Mailing Address - Street 1:1299 OLENTANGY RIVER RD
Mailing Address - Street 2:STE 103
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212
Mailing Address - Country:US
Mailing Address - Phone:614-566-4278
Mailing Address - Fax:614-566-5424
Practice Address - Street 1:111 S GRANT AVE
Practice Address - Street 2:3RD FL
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215
Practice Address - Country:US
Practice Address - Phone:614-566-8808
Practice Address - Fax:614-566-9503
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OHRN165554367500000X
OHNA03757367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered