Provider Demographics
NPI:1700095536
Name:MARTIN, KAREN S (RN, CRNI)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:S
Last Name:MARTIN
Suffix:
Gender:F
Credentials:RN, CRNI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-3201
Mailing Address - Country:US
Mailing Address - Phone:717-697-3785
Mailing Address - Fax:717-697-3785
Practice Address - Street 1:491A BLUE EAGLE AVE
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-2314
Practice Address - Country:US
Practice Address - Phone:717-651-9996
Practice Address - Fax:717-651-9974
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN297588L163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARN297588LOtherSTATE LICENSE