Provider Demographics
NPI:1376200774
Name:NEWHART, KARYN JO (CRNP)
Entity Type:Individual
Prefix:
First Name:KARYN
Middle Name:JO
Last Name:NEWHART
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:KARYN
Other - Middle Name:JO
Other - Last Name:NESBIT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2776 SR 307
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:PA
Mailing Address - Zip Code:18414-7930
Mailing Address - Country:US
Mailing Address - Phone:570-903-1868
Mailing Address - Fax:
Practice Address - Street 1:1111 E END BLVD
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18711-0030
Practice Address - Country:US
Practice Address - Phone:570-824-3521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-19
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP024862363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily