Basic Information
| Provider Information | |||||||||
| NPI: | 1033558325 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HUDAC | ||||||||
| FirstName: | KARINA | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | LPN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 170 SHAFFER RD | ||||||||
| Address2: | |||||||||
| City: | SEWICKLEY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 151439684 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7242668609 | ||||||||
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| Practice Location | |||||||||
| Address1: | 659 3RD ST | ||||||||
| Address2: | |||||||||
| City: | BEAVER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150092115 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7247751118 | ||||||||
| FaxNumber: | 7247752375 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2013 | ||||||||
| LastUpdateDate: | 06/19/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164W00000X | PN257405L | PA | Y | Nursing Service Providers | Licensed Practical Nurse |
No ID Information.