Basic Information
Provider Information
NPI: 1407282163
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KARLI
FirstName: ASHLEY
MiddleName: MARIE
NamePrefix: MISS
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 307 S FRONT ST
Address2: FIRST FLOOR
City: HARRISBURG
State: PA
PostalCode: 171041621
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 4300 LONDONDERRY RD
Address2:  
City: HARRISBURG
State: PA
PostalCode: 171095317
CountryCode: US
TelephoneNumber: 7172318772
FaxNumber: 7172318435
Other Information
ProviderEnumerationDate: 09/25/2013
LastUpdateDate: 01/21/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000XMA056403PAN Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 
363AM0700XMA056403PAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical

No ID Information.


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