Provider Demographics
NPI:1518291749
Name:KREBS, KARLIN TATE (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:KARLIN
Middle Name:TATE
Last Name:KREBS
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10657 BRADDOCK RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22032-2202
Mailing Address - Country:US
Mailing Address - Phone:703-691-4700
Mailing Address - Fax:703-691-4791
Practice Address - Street 1:10657 BRADDOCK RD
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22032-2202
Practice Address - Country:US
Practice Address - Phone:703-691-4700
Practice Address - Fax:703-691-4791
Is Sole Proprietor?:No
Enumeration Date:2009-09-21
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024168423363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics