Provider Demographics
NPI:1447403431
Name:MARTYN, KARON (CRNP)
Entity Type:Individual
Prefix:
First Name:KARON
Middle Name:
Last Name:MARTYN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:KARYN
Other - Middle Name:
Other - Last Name:CANADAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1200 OLD YORK RD
Mailing Address - Street 2:1 WIDENER
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-3720
Mailing Address - Country:US
Mailing Address - Phone:215-481-2400
Mailing Address - Fax:215-481-7438
Practice Address - Street 1:1200 OLD YORK RD
Practice Address - Street 2:1 WIDENER
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3720
Practice Address - Country:US
Practice Address - Phone:215-481-2400
Practice Address - Fax:215-481-7438
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN522924L163WX0200X
PASP009988363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WX0200XNursing Service ProvidersRegistered NurseOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102384911Medicaid