Provider Demographics
NPI:1366473613
Name:RAMSDELL, KAREN KIMM (PA)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:KIMM
Last Name:RAMSDELL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:LEE
Other - Last Name:KIMM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 751649
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1649
Mailing Address - Country:US
Mailing Address - Phone:843-789-1620
Mailing Address - Fax:843-724-2440
Practice Address - Street 1:1350 CONNECTICUT AVE NW STE 1250
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-1728
Practice Address - Country:US
Practice Address - Phone:888-663-6631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC785363AM0700X
DCPA200001580363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0769PAMedicaid
SCP00829102OtherRAILROAD MEDICARE ID-RSFPN
SCP775545551Medicare PIN
SCP00829102OtherRAILROAD MEDICARE ID-RSFPN
SC0769PAMedicaid