Provider Demographics
NPI:1851323521
Name:HALPIN, MARILYN CARMAN (CRNP)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:CARMAN
Last Name:HALPIN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:MARILYN
Other - Middle Name:H
Other - Last Name:CARMAN-ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:396 BROADWAY
Mailing Address - Street 2:MID HUDSON PHYSICIANS, PC
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-4626
Mailing Address - Country:US
Mailing Address - Phone:845-331-3131
Mailing Address - Fax:845-334-2898
Practice Address - Street 1:396 BROADWAY
Practice Address - Street 2:MID HUDSON PHYSICIANS, PC
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-4626
Practice Address - Country:US
Practice Address - Phone:845-331-3131
Practice Address - Fax:845-334-2898
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY30-333536363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02225047Medicaid
NYA400073413Medicare PIN
PA1437428OtherHIGHMARK BLUE SHIELD
PAP00094666OtherRAILROAD MEDICARE
PAP52903Medicare UPIN