Provider Demographics
NPI:1619192200
Name:WARE, KAREN L (PA-C)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:L
Last Name:WARE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 GRANDVIEW AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-1708
Mailing Address - Country:US
Mailing Address - Phone:717-218-3920
Mailing Address - Fax:717-218-3921
Practice Address - Street 1:1211 FORGE RD
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-3168
Practice Address - Country:US
Practice Address - Phone:717-218-3920
Practice Address - Fax:717-218-3921
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110001682363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1134342140Medicaid
VA1134342140Medicaid
VA0472640017Medicare NSC