Provider Demographics
NPI:1164483962
Name:O'DAY, KAREN C (CNM, CFNP, MBA)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:C
Last Name:O'DAY
Suffix:
Gender:F
Credentials:CNM, CFNP, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 5TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-5403
Mailing Address - Country:US
Mailing Address - Phone:505-780-8301
Mailing Address - Fax:505-780-5418
Practice Address - Street 1:1911 5TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-5403
Practice Address - Country:US
Practice Address - Phone:505-780-8301
Practice Address - Fax:505-780-5418
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR25968363LF0000X
NM462367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM201032100OtherPRESBYTERIAN HEALTH/SALUD
NM000G0919Medicaid
NMG0889Medicaid
NM00NM006227OtherBLUE CROSS BLUE SHIELD
NM68638OtherPRESBYTERIAN HEALTH/SALUD
NM850482276OtherOTHER INSURANCES
NM000G0919Medicaid
NM00NM006227OtherBLUE CROSS BLUE SHIELD
NHRE7915Medicare UPIN