Healthcare Provider Details
I. General information
NPI: 1679555973
Provider Name (Legal Business Name): KAREN KAY BECKLEY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/14/2005
Last Update Date: 11/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
899 POPLAR CHURCH RD
CAMP HILL PA
17011-2206
US
IV. Provider business mailing address
899 POPLAR CHURCH RD
CAMP HILL PA
17011-2206
US
V. Phone/Fax
- Phone: 717-763-0430
- Fax: 717-763-9854
- Phone: 717-763-0430
- Fax: 717-763-9854
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | RN159088L |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: