Provider Demographics
NPI:1033558325
Name:HUDAC, KARINA R (LPN)
Entity Type:Individual
Prefix:
First Name:KARINA
Middle Name:R
Last Name:HUDAC
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 SHAFFER RD
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-9684
Mailing Address - Country:US
Mailing Address - Phone:724-266-8609
Mailing Address - Fax:
Practice Address - Street 1:659 3RD ST
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-2115
Practice Address - Country:US
Practice Address - Phone:724-775-1118
Practice Address - Fax:724-775-2375
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN257405L164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse