Provider Demographics
NPI:1114051877
Name:MCCARTHY, KAREN S (RN, ANP)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:S
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:RN, ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2200 PARK BEND DR STE 300
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5386
Mailing Address - Country:US
Mailing Address - Phone:512-651-8644
Mailing Address - Fax:512-651-8635
Practice Address - Street 1:2200 PARK BEND DR STE 300
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5386
Practice Address - Country:US
Practice Address - Phone:512-651-8644
Practice Address - Fax:512-651-8635
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP109542363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX142139803Medicaid
342164YMVUOtherWELLMED NETWORKS INC
TX142139803Medicaid