Provider Demographics
NPI:1154651636
Name:BORICH, KAREN L (RN, MSN, CPNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:L
Last Name:BORICH
Suffix:
Gender:F
Credentials:RN, MSN, CPNP
Other - Prefix:MISS
Other - First Name:KAREN
Other - Middle Name:L
Other - Last Name:SABO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, MSN, CPNP
Mailing Address - Street 1:1810 KENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-3632
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1807 WEST SLAUGHTER LANE
Practice Address - Street 2:SUITE 490
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-3632
Practice Address - Country:US
Practice Address - Phone:512-282-8967
Practice Address - Fax:512-292-5143
Is Sole Proprietor?:No
Enumeration Date:2010-01-06
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX642105363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX210407701Medicaid
TX642105OtherRN LICENSE
TX210407702Medicaid
TX210407701Medicaid
TX8L25771Medicare PIN