Provider Demographics
NPI:1346434206
Name:STADD, KAREN AILEEN (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:AILEEN
Last Name:STADD
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 1:601 N WOLFE ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-3200
Mailing Address - Country:US
Mailing Address - Phone:410-955-5255
Mailing Address - Fax:410-614-8834
Practice Address - Street 1:601 N WOLFE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0004
Practice Address - Country:US
Practice Address - Phone:410-955-5255
Practice Address - Fax:410-614-8834
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR115148363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care