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General NPI Number Information
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NPI Number | 1699310409
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Entity Type | Individual
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Provider Name | KAREN ELIZABETH JANKE
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Gender | Female
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Dates
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Enumeration Date | 11/15/2019
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Last Update Date | 06/02/2020
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Provider Practice Location Address
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Address Line | 14085 CROWN CT
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City | WOODBRIDGE
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State | VA
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Zip | 22193-1458
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Country | US
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Telephone | 703-763-5224
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Fax |
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Provider Business Mailing Address
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Address Line | 4149 CHATHAM HILL DR
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City | WINSTON SALEM
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State | NC
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Zip | 27104-1439
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Country | US
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Telephone | 336-403-1232
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 5012536
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 0024179361
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License Number State | VA
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