Provider Demographics
NPI:1386857274
Name:ROCKWELL, KAREN A (NP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:ROCKWELL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 W SPROUL RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-2027
Mailing Address - Country:US
Mailing Address - Phone:610-338-1820
Mailing Address - Fax:610-338-1825
Practice Address - Street 1:190 W SPROUL RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-2027
Practice Address - Country:US
Practice Address - Phone:610-338-1820
Practice Address - Fax:610-338-1825
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009270363L00000X
DELG-0000429363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE022431C49Medicare PIN
DE022381C04Medicare PIN