Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | R053757 | MD |
N | 363LP0200X | Nurse Practitioner - Pediatrics | R053757 | MD |
Y | 363LP0200X | Nurse Practitioner - Pediatrics | SP010116 | PA |
NPI | 1033273644 |
---|---|
Provider Name | Ms. Karen Kelly Buch |
First Address | Gettysburg, PA 17325-7281 |
Second Address | Gettysburg, PA 17325-7281 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2006 |
Last Update Date | 06/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1028017650001 | (05) | PA |