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NPI Code Detail

MEDICARE: MRS. KAREN DAHLQUIST CRNP

MEDICARE: MRS. KAREN DAHLQUIST CRNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QH0100XHealth Service Clinic/CenterUP004867BPA

General Provider Information

NPI Number : 1225159544
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KAREN DAHLQUIST CRNP
Provider Business Mailing Address
First Line : 214 COLONIAL AVE
Second Line :
City : WOODBURY
State : NJ
Zip : 08096-1008
Country : US
Telephone Number : 856-845-0578
Fax Number :
Provider Business Practice Location Address
First Line : 4201 HENRY AVE
Second Line : PHILADELPHIA UNIVERSITY STUDENT HEALTH CENTER
City : PHILADELPHIA
State : PA
Zip : 19144-5409
Country : US
Telephone Number : 215-951-2986
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2007
Last Update Date : 07/08/2007

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