Provider Demographics
NPI:1093397465
Name:WITTMER, KAREN ELAINE (LPN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ELAINE
Last Name:WITTMER
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 1:1045 4TH AVE PIONEER BLDG
Mailing Address - Street 2:
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068
Mailing Address - Country:US
Mailing Address - Phone:724-335-9883
Mailing Address - Fax:724-335-2867
Practice Address - Street 1:1045 4TH AVE PIONEER BLDG
Practice Address - Street 2:
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-1506
Practice Address - Country:US
Practice Address - Phone:724-335-9883
Practice Address - Fax:724-335-2867
Is Sole Proprietor?:No
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN054528L164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse