Provider Demographics
NPI:1821109661
Name:HLYWA, KAREN A (RN, OGNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:HLYWA
Suffix:
Gender:F
Credentials:RN, OGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 HOSPITAL DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-8451
Mailing Address - Country:US
Mailing Address - Phone:540-656-2830
Mailing Address - Fax:540-656-2856
Practice Address - Street 1:1300 HOSPITAL DR
Practice Address - Street 2:SUITE 300
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-8451
Practice Address - Country:US
Practice Address - Phone:540-656-2830
Practice Address - Fax:540-656-2856
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0017000782207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA500000700Medicare ID - Type Unspecified
P25293Medicare UPIN