Provider Demographics
NPI:1477559136
Name:SMITH, KAREN ANN (CRNA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ANN
Last Name:SMITH
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:ANN
Other - Last Name:HARTNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:118 OVERLOOK AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON CROSSING
Mailing Address - State:PA
Mailing Address - Zip Code:18977-1204
Mailing Address - Country:US
Mailing Address - Phone:215-888-0385
Mailing Address - Fax:
Practice Address - Street 1:KNIGHTS ROAD & RED LION ROAD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-4427
Practice Address - Country:US
Practice Address - Phone:215-612-4089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN511670L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA056139Medicare ID - Type Unspecified