Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | LJ-0010394 | DE |
N | 363LP0200X | Nurse Practitioner - Pediatrics | SP009519 | PA |
NPI | 1033306493 |
---|---|
Provider Name | Mrs. Karen Veronica Mccandless |
First Address | Wilmington, DE 19803-3607 |
Second Address | Wilmington, DE 19803-3607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2007 |
Last Update Date | 28/06/2021 |