Healthcare Provider Details

I. General information

NPI: 1336101971
Provider Name (Legal Business Name): KAREN POWELL CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 COMMUNITY DR POCONO OBSTETRICS AND GYNECOLOGY. SUITE 205
TOBYHANNA PA
18466-8985
US

IV. Provider business mailing address

206 E BROWN ST POCONO HEALTHCARE MGMT. - PROFESSIONAL BLDG.
E STROUDSBURG PA
18301-3006
US

V. Phone/Fax

Practice location:
  • Phone: 570-895-4331
  • Fax: 570-895-4332
Mailing address:
  • Phone: 570-420-4969
  • Fax: 570-476-3754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberSP001223G
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: