Provider Demographics
NPI:1417183112
Name:SWEENEY, KAREN (PA-C, MHS)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:PA-C, MHS
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:ANN
Other - Last Name:KRAUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:742 CORNWALLIS DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-3247
Mailing Address - Country:US
Mailing Address - Phone:856-778-5507
Mailing Address - Fax:
Practice Address - Street 1:40 W EVERGREEN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19118-3324
Practice Address - Country:US
Practice Address - Phone:215-248-6025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-08
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA-00414-L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant