Provider Demographics
NPI:1932124443
Name:CALLAHAN, KAREN B (FNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:B
Last Name:CALLAHAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10470 OLD PLACERVILLE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2539
Mailing Address - Country:US
Mailing Address - Phone:800-470-0071
Mailing Address - Fax:
Practice Address - Street 1:969 PLUMAS ST
Practice Address - Street 2:STE 103
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-4011
Practice Address - Country:US
Practice Address - Phone:530-749-3585
Practice Address - Fax:530-749-3499
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CANPF5796363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00785483OtherRAILROAD MEDICARE
CI681ZMedicare PIN
R21498Medicare UPIN