Provider Demographics
NPI:1386150332
Name:PRIESTER, KARLA MARIE (RN, BSN)
Entity type:Individual
Prefix:MS
First Name:KARLA
Middle Name:MARIE
Last Name:PRIESTER
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 ALBERTA DR STE 2
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1139
Mailing Address - Country:US
Mailing Address - Phone:716-832-0720
Mailing Address - Fax:716-832-5867
Practice Address - Street 1:575 ALBERTA DR STE 2
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1139
Practice Address - Country:US
Practice Address - Phone:716-832-0720
Practice Address - Fax:716-832-5867
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-28
Last Update Date:2017-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY503238163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent