Provider Demographics
NPI:1447556113
Name:BADELLINO, KAREN OTTO (ANP-BC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:OTTO
Last Name:BADELLINO
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:LYNN
Other - Last Name:BADELLINO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ANP-BC
Mailing Address - Street 1:PO BOX 420
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18962-0420
Mailing Address - Country:US
Mailing Address - Phone:215-258-3810
Mailing Address - Fax:215-258-3815
Practice Address - Street 1:164 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:PA
Practice Address - Zip Code:18962-0420
Practice Address - Country:US
Practice Address - Phone:215-258-3810
Practice Address - Fax:215-258-3815
Is Sole Proprietor?:No
Enumeration Date:2011-01-28
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010913363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health