Provider Demographics
NPI:1578166492
Name:PRAHLER, KAREN ANN (CRNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ANN
Last Name:PRAHLER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:ANN
Other - Last Name:REARDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2436 WOODLAND CT
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE BEACH
Mailing Address - State:MD
Mailing Address - Zip Code:20732-4606
Mailing Address - Country:US
Mailing Address - Phone:570-556-8588
Mailing Address - Fax:
Practice Address - Street 1:130 HOSPITAL RD STE 102
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-4029
Practice Address - Country:US
Practice Address - Phone:570-556-8588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-21
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR234785363LF0000X
KY1165256163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse