Provider Demographics
NPI:1619943974
Name:KARG, PAMELA S (MSN, CRNP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:S
Last Name:KARG
Suffix:
Gender:F
Credentials:MSN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 DOCTORS LN
Mailing Address - Street 2:
Mailing Address - City:CLARION
Mailing Address - State:PA
Mailing Address - Zip Code:16214-8515
Mailing Address - Country:US
Mailing Address - Phone:814-226-3470
Mailing Address - Fax:814-226-3479
Practice Address - Street 1:24 DOCTORS LN
Practice Address - Street 2:SUITE 101
Practice Address - City:CLARION
Practice Address - State:PA
Practice Address - Zip Code:16214-8514
Practice Address - Country:US
Practice Address - Phone:814-226-6070
Practice Address - Fax:814-226-4505
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP008459363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAQ31917Medicare UPIN
PA086695Medicare ID - Type Unspecified