Provider Demographics
NPI:1932172673
Name:SAMPSON, KAREN S (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:S
Last Name:SAMPSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:S
Other - Last Name:PEARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 302
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16354-0302
Mailing Address - Country:US
Mailing Address - Phone:814-827-9770
Mailing Address - Fax:814-827-3556
Practice Address - Street 1:406 W OAK ST
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:PA
Practice Address - Zip Code:16354-1404
Practice Address - Country:US
Practice Address - Phone:814-827-9770
Practice Address - Fax:814-827-3556
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP005455B363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P27501Medicare UPIN