Provider Demographics
NPI:1295385870
Name:KARIUKI, JOAN (CRNP)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:KARIUKI
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 1:1952 PULASKI HWY
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:21040-1658
Mailing Address - Country:US
Mailing Address - Phone:410-676-1463
Mailing Address - Fax:410-676-0864
Practice Address - Street 1:1952 PULASKI HWY
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:MD
Practice Address - Zip Code:21040-1658
Practice Address - Country:US
Practice Address - Phone:410-676-1463
Practice Address - Fax:410-676-0864
Is Sole Proprietor?:No
Enumeration Date:2019-09-16
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR205509363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily