Provider Demographics
NPI:1740931914
Name:KARNJA, FREDRICK (RN BSN)
Entity type:Individual
Prefix:MR
First Name:FREDRICK
Middle Name:
Last Name:KARNJA
Suffix:
Gender:M
Credentials:RN BSN
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:N/A
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:N/A
Mailing Address - Street 1:35 DALE CT
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-4003
Mailing Address - Country:US
Mailing Address - Phone:302-257-1079
Mailing Address - Fax:302-762-1697
Practice Address - Street 1:3604 MILLER RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-2524
Practice Address - Country:US
Practice Address - Phone:302-257-1079
Practice Address - Fax:302-762-1697
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0036928163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1425508OtherDRIVER LICENSE