Provider Demographics
NPI:1821153925
Name:FOX, KAREN LYNNE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:LYNNE
Last Name:FOX
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10110 MOLECULAR DRIVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-7542
Mailing Address - Country:US
Mailing Address - Phone:301-279-2779
Mailing Address - Fax:240-403-0190
Practice Address - Street 1:10110 MOLECULAR DRIVE
Practice Address - Street 2:SUITE 206
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-7542
Practice Address - Country:US
Practice Address - Phone:301-279-2779
Practice Address - Fax:240-403-0190
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR097054363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD227221100Medicaid
DC145175Y5KMedicare PIN