Provider Demographics
NPI:1760067128
Name:STANG, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:STANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3226 SHARP RD
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:21738-9402
Mailing Address - Country:US
Mailing Address - Phone:443-812-3456
Mailing Address - Fax:
Practice Address - Street 1:3226 SHARP RD
Practice Address - Street 2:
Practice Address - City:GLENWOOD
Practice Address - State:MD
Practice Address - Zip Code:21738-9402
Practice Address - Country:US
Practice Address - Phone:443-812-3456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker