Healthcare Provider Details

I. General information

NPI: 1447403431
Provider Name (Legal Business Name): KARON MARTYN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARYN CANADAY

II. Dates (important events)

Enumeration Date: 11/04/2008
Last Update Date: 05/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 OLD YORK RD 1 WIDENER
ABINGTON PA
19001-3720
US

IV. Provider business mailing address

1200 OLD YORK RD 1 WIDENER
ABINGTON PA
19001-3720
US

V. Phone/Fax

Practice location:
  • Phone: 215-481-2400
  • Fax: 215-481-7438
Mailing address:
  • Phone: 215-481-2400
  • Fax: 215-481-7438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License NumberRN522924L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberSP009988
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: