Provider Demographics
NPI:1659395895
Name:LUMSDEN, KAREN CRAWFORD (PA-C)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:CRAWFORD
Last Name:LUMSDEN
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:PO BOX 3339
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22402-3339
Mailing Address - Country:US
Mailing Address - Phone:855-739-9953
Mailing Address - Fax:888-463-3944
Practice Address - Street 1:300 PARK HILL DR
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401
Practice Address - Country:US
Practice Address - Phone:540-361-7641
Practice Address - Fax:540-361-1246
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110-840857363A00000X
KYPA2411363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1659395895Medicaid
VA540896390OtherTRICARE
VA1659395895Medicaid