Provider Demographics
NPI:1033443312
Name:RETIRADO, KAREN ELIZABETH (APN-C)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ELIZABETH
Last Name:RETIRADO
Suffix:
Gender:F
Credentials:APN-C
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:ELIZABETH
Other - Last Name:ESNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN-C
Mailing Address - Street 1:15 DORCHESTER DRIVE
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920
Mailing Address - Country:US
Mailing Address - Phone:732-841-5697
Mailing Address - Fax:612-225-1591
Practice Address - Street 1:15 DORCHESTER DRIVE
Practice Address - Street 2:
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920
Practice Address - Country:US
Practice Address - Phone:732-841-5697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-20
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00248500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily