Provider Demographics
NPI:1649239088
Name:KAMINSKI, KAREN M (CRNP)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:M
Last Name:KAMINSKI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
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Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:1155 E MOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-7906
Practice Address - Country:US
Practice Address - Phone:570-808-6113
Practice Address - Fax:570-808-6349
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAUP004006B363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
S48186Medicare UPIN
PA005250Medicare ID - Type Unspecified