Healthcare Provider Details

I. General information

NPI: 1316268899
Provider Name (Legal Business Name): JEANNE KARSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2010
Last Update Date: 11/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

384 CRYSTAL RUN RD SUITE 201
MIDDLETOWN NY
10941-4013
US

IV. Provider business mailing address

384 CRYSTAL RUN RD SUITE 201
MIDDLETOWN NY
10941-4013
US

V. Phone/Fax

Practice location:
  • Phone: 845-692-8780
  • Fax: 845-692-3439
Mailing address:
  • Phone: 845-692-8780
  • Fax: 845-692-3439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF305391-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: