Provider Demographics
NPI:1194041079
Name:FACTOR, KAREN FISCHER
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:FISCHER
Last Name:FACTOR
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:KAREN
Other - Middle Name:DOVE
Other - Last Name:FISCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD LDN
Mailing Address - Street 1:5104 GREYFIELD BLVD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-8140
Mailing Address - Country:US
Mailing Address - Phone:919-599-6467
Mailing Address - Fax:
Practice Address - Street 1:5104 GREYFIELD BLVD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-8140
Practice Address - Country:US
Practice Address - Phone:919-599-6467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-16
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL001144133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered