Provider Demographics
NPI:1154412559
Name:LEVIN, KAREN S (CRNP)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:S
Last Name:LEVIN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:S
Other - Last Name:GUMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:PO BOX 79632
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21279-0632
Mailing Address - Country:US
Mailing Address - Phone:301-762-5020
Mailing Address - Fax:301-309-3783
Practice Address - Street 1:1201 SEVEN LOCKS RD
Practice Address - Street 2:SUITE 111
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20854-2957
Practice Address - Country:US
Practice Address - Phone:301-762-5020
Practice Address - Fax:301-294-7569
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR116045363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD418093300Medicaid
DC196347Medicare PIN
MD418093300Medicaid
DC158235Medicare PIN