Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0200X | Nurse Practitioner - Pediatrics | F380671 | NY |
Y | 363LP0200X | Nurse Practitioner - Pediatrics | SP017218 | PA |
NPI | 1003829995 |
---|---|
Provider Name | Karen Chalanick |
First Address | Rochester, NY 14642-0001 |
Second Address | Gettysburg, PA 17325-2534 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02197006 | (05) | NY |
PENDING | (05) | PA |