Provider Demographics
NPI:1033273644
Name:BUCH, KAREN KELLY (RN CPNP CANP)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:KELLY
Last Name:BUCH
Suffix:
Gender:F
Credentials:RN CPNP CANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:11 HUNTERS TRL
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-7281
Mailing Address - Country:US
Mailing Address - Phone:717-334-7681
Mailing Address - Fax:717-334-0730
Practice Address - Street 1:11 HUNTERS TRL
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-7281
Practice Address - Country:US
Practice Address - Phone:717-334-7681
Practice Address - Fax:717-334-0730
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2014-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR053757163W00000X, 363LA2200X, 363LP0200X
PASP010116363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1028017650001Medicaid