Healthcare Provider Details
I. General information
NPI: 1447240817
Provider Name (Legal Business Name): MELANIE KARA KAVITSKY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/26/2005
Last Update Date: 03/15/2025
Certification Date: 03/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 CAPITAL WAY
PENNINGTON NJ
08534-2520
US
IV. Provider business mailing address
647 VALLEY STREAM CIRCLE
LANGEHORNE PA
19053
US
V. Phone/Fax
- Phone: 609-396-4700
- Fax: 609-396-4900
- Phone: 215-891-9982
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | 26NR1127600 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | RN533110 |
| License Number State | PA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | 075022 |
| License Number State | PA |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 364S00000X |
| Taxonomy | Clinical Nurse Specialist |
| License Number | 26NJ00210500 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: