Provider Demographics
NPI:1477785707
Name:KLANAC, KARMEN (PA)
Entity Type:Individual
Prefix:MRS
First Name:KARMEN
Middle Name:
Last Name:KLANAC
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MRS
Other - First Name:KARMEN
Other - Middle Name:
Other - Last Name:SLABIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:10775 PIONEER TRL STE 215
Mailing Address - Street 2:
Mailing Address - City:TRUCKEE
Mailing Address - State:CA
Mailing Address - Zip Code:96161-0234
Mailing Address - Country:US
Mailing Address - Phone:415-424-4266
Mailing Address - Fax:
Practice Address - Street 1:10775 PIONEER TRL STE 215
Practice Address - Street 2:
Practice Address - City:TRUCKEE
Practice Address - State:CA
Practice Address - Zip Code:96161
Practice Address - Country:US
Practice Address - Phone:415-424-4266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7396363A00000X
FLPA9111462363A00000X
TXPA05246363A00000X
COPA0005659363A00000X
CA55221363A00000X
NVPA2124363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant