Provider Demographics
NPI:1255757357
Name:MCCLAIN, KAREN (ANP)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:MARIE
Other - Last Name:GIRARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:116 INTERSTATE PKWY
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:PA
Mailing Address - Zip Code:16701-1036
Mailing Address - Country:US
Mailing Address - Phone:814-368-4143
Mailing Address - Fax:
Practice Address - Street 1:116 INTERSTATE PKWY STE 41
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:PA
Practice Address - Zip Code:16701-1036
Practice Address - Country:US
Practice Address - Phone:814-368-4143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-13
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP013853363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health