Healthcare Provider Details

I. General information

NPI: 1982302188
Provider Name (Legal Business Name): KAREN T FAY CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2023
Last Update Date: 02/22/2023
Certification Date: 02/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 THOMAS JONES WAY
EXTON PA
19341-2531
US

IV. Provider business mailing address

845 COLONY CT
BRYN MAWR PA
19010-1100
US

V. Phone/Fax

Practice location:
  • Phone: 484-873-3700
  • Fax: 484-813-6199
Mailing address:
  • Phone: 610-247-5825
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberSP026681
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberSP026681
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: