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NPI 1417352550

NPI 1417352550 : KAREN MCMANN : MARTINSBURG, WV

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General NPI Number Information
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    NPI Number           |    1417352550
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    Entity Type          |    Individual 
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    Provider Name        |    KAREN MCMANN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/31/2014
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    Last Update Date     |    01/04/2019
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Provider Practice Location Address
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    Address Line         |    510 BUTLER AVE 
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    City                 |    MARTINSBURG
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    State                |    WV
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    Zip                  |    25405-9990
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    Country              |    US
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    Telephone            |    304-268-9640
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    510 BUTLER AVE 
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    City                 |    MARTINSBURG
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    State                |    WV
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    Zip                  |    25405-9990
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    Country              |    US
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    Telephone            |    304-268-9640
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363L00000X
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    Taxonomy Name        |    Nurse Practitioner
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    License Number       |    AC002423
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    License Number State |    MD
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Taxonomy #2
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    Taxonomy Code        |    363L00000X
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    Taxonomy Name        |    Nurse Practitioner
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    License Number       |    0024172194
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    License Number State |    VA
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