Provider Demographics
NPI:1609842160
Name:SHAUGER, KAREN G (CRNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:G
Last Name:SHAUGER
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 1:306 E LANCASTER AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-2105
Mailing Address - Country:US
Mailing Address - Phone:484-476-7222
Mailing Address - Fax:484-476-7853
Practice Address - Street 1:306 E LANCASTER AVE STE 400
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-2105
Practice Address - Country:US
Practice Address - Phone:484-476-7222
Practice Address - Fax:484-476-7853
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP004205B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
S60735Medicare UPIN
S60735Medicare UPIN
TN36402761Medicare PIN
PA440771OtherMLHC MEDICARE AA #
TN36402762Medicare PIN