Provider Demographics
NPI:1699714667
Name:ALTOBELLI, KAREN L (FNP-BC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:L
Last Name:ALTOBELLI
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2851 BAGLYOS CIR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-8033
Mailing Address - Country:US
Mailing Address - Phone:610-867-7134
Mailing Address - Fax:610-867-7108
Practice Address - Street 1:2851 BAGLYOS CIR
Practice Address - Street 2:SUITE 201
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-8033
Practice Address - Country:US
Practice Address - Phone:610-867-7134
Practice Address - Fax:610-867-7108
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP007148363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAAL1390303OtherHIGHMARK BLUE SHIELD
PA50047066OtherKEYSTONE HEALTH PLAN CENT
PA007071427OtherAETNA USHC
PA50047066OtherCAPITAL BLUE CROSS
PA50047066OtherCAPITAL BLUE CROSS
PA061083QW4Medicare ID - Type Unspecified