Provider Demographics
NPI:1225159544
Name:DAHLQUIST, KAREN (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:
Last Name:DAHLQUIST
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 COLONIAL AVE
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-1008
Mailing Address - Country:US
Mailing Address - Phone:856-845-0578
Mailing Address - Fax:
Practice Address - Street 1:4201 HENRY AVE
Practice Address - Street 2:PHILADELPHIA UNIVERSITY STUDENT HEALTH CENTER
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-5409
Practice Address - Country:US
Practice Address - Phone:215-951-2986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP004867B261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service