Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | R50998 | ND |
N | 363LN0000X | Nurse Practitioner - Neonatal | SP009727 | PA |
NPI | 1205160611 |
---|---|
Provider Name | Karen Caputo |
First Address | East Stroudsburg, PA 18301-3006 |
Second Address | East Stroudsburg, PA 18301-3006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2009 |
Last Update Date | 02/11/2021 |