Provider Demographics
NPI:1831192772
Name:KEPNER, KAREN DUZICK (MSN, CRNP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:DUZICK
Last Name:KEPNER
Suffix:
Gender:F
Credentials:MSN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 CENTRE ST
Mailing Address - Street 2:ALTERNAMED, LLC
Mailing Address - City:ASHLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17921-1243
Mailing Address - Country:US
Mailing Address - Phone:570-875-2308
Mailing Address - Fax:570-875-3721
Practice Address - Street 1:913 CENTRE ST
Practice Address - Street 2:ALTERNAMED, LLC
Practice Address - City:ASHLAND
Practice Address - State:PA
Practice Address - Zip Code:17921-1243
Practice Address - Country:US
Practice Address - Phone:570-875-2308
Practice Address - Fax:570-875-3721
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP004067B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1015065910001Medicaid
KE003503Medicare ID - Type Unspecified
PA1015065910001Medicaid