Provider Demographics
NPI:1568452068
Name:KARNS, GARRICK S (CRNA)
Entity Type:Individual
Prefix:
First Name:GARRICK
Middle Name:S
Last Name:KARNS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 S CEDAR CREST BLVD
Mailing Address - Street 2:SUITE #301
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6258
Mailing Address - Country:US
Mailing Address - Phone:610-402-9099
Mailing Address - Fax:610-402-9029
Practice Address - Street 1:1200 S CEDAR CREST BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6202
Practice Address - Country:US
Practice Address - Phone:610-402-9099
Practice Address - Fax:610-402-9029
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN--502174-L163W00000X
PA053352367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1877539OtherFIRST PRIORITY
PA101402OtherGEISINGER
PA1584022OtherGATEWAY
PA1877539OtherHIGHMARK
PA2738280000OtherIBC
PA9051464OtherAETNA
PA50060465OtherCAPITAL ADVANTAGE
PA11803031OtherCAQH
PA50077159OtherCAPITAL BLUE CROSS, KEYSTONE CENTRAL, SENIOR BLUE
PA1027796460001Medicaid
PA1584022OtherGATEWAY
PA11803031OtherCAQH
PA100071Q1RMedicare PIN
PA1877539OtherHIGHMARK
PA101402OtherGEISINGER
PAP43811Medicare UPIN
PA100071QCYMedicare PIN