1710954714 NPI number — MS. KAREN MARY STILP CRNP

Table of content: (NPI 1598705782)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710954714 NPI number — MS. KAREN MARY STILP CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STILP
Provider First Name:
KAREN
Provider Middle Name:
MARY
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
CRNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710954714
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/31/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
38C HALL MNR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARRISBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17104-3081
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-233-1700
Provider Business Mailing Address Fax Number:
717-236-8752

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
38C HALL MNR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17104-3081
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-233-1700
Provider Business Practice Location Address Fax Number:
717-236-8752
Provider Enumeration Date:
03/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LX0001X , with the licence number:  UP003626G , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0205300 . This is a "HIGHMARK BLUE CROSS #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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