=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558487967
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SANDRA KAY KARST RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/21/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3774 RIDGE PIKE SUITE 101
-----------------------------------------------------
City | COLLEGEVILLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19426-3169
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-489-3333
-----------------------------------------------------
Fax | 610-489-9390
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 903 NICHOLSON AVE
-----------------------------------------------------
City | DOUGLASSVILLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19518-1539
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-385-6050
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WP0809X
-----------------------------------------------------
Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
-----------------------------------------------------
License Number | RN514670L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------