Provider Demographics
NPI:1821096959
Name:LARAWAY, KAREN (ANP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:LARAWAY
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:LARAWAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ANP
Mailing Address - Street 1:703 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-3082
Mailing Address - Country:US
Mailing Address - Phone:856-727-0900
Mailing Address - Fax:856-231-8428
Practice Address - Street 1:703 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3082
Practice Address - Country:US
Practice Address - Phone:856-727-0900
Practice Address - Fax:856-231-8428
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNN31365363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP00180790OtherRAILROAD MEDICARE
NJP00180790OtherRAILROAD MEDICARE
NJ003970CSFMedicare PIN