Healthcare Provider Details

I. General information

NPI: 1245442961
Provider Name (Legal Business Name): KAREN CELESTINE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PHILADELPHIA HEALTH CARE CENTER #4 4400 HAVERFORD AVE
PHILADELPHIA PA
19104
US

IV. Provider business mailing address

8105 TEMPLE RD
PHILADELPHIA PA
19150-1217
US

V. Phone/Fax

Practice location:
  • Phone: 215-685-7601
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN572742
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: