Provider Demographics
NPI:1689661654
Name:SROKA, KAREN JEAN (GNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:JEAN
Last Name:SROKA
Suffix:
Gender:F
Credentials:GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3414 ESTONIA DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1263
Mailing Address - Country:US
Mailing Address - Phone:301-249-3324
Mailing Address - Fax:866-908-7026
Practice Address - Street 1:8015 APPLE VALLEY DR
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-4174
Practice Address - Country:US
Practice Address - Phone:410-255-0102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR131555363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP24698Medicare UPIN