Provider Demographics
NPI:1508264771
Name:GOLDSTEIN, KARA L (CRNP)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:L
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2103 BASSWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19444-2329
Mailing Address - Country:US
Mailing Address - Phone:610-941-0399
Mailing Address - Fax:
Practice Address - Street 1:233 E LANCASTER AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:ARDMORE
Practice Address - State:PA
Practice Address - Zip Code:19003-2321
Practice Address - Country:US
Practice Address - Phone:610-896-8009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-19
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP003090O363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics