Provider Demographics
NPI:1225001209
Name:SPITLER, KAREN D (APRN, BC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:D
Last Name:SPITLER
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 TELEGRAPH HILL RD
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02050-2523
Mailing Address - Country:US
Mailing Address - Phone:781-837-7270
Mailing Address - Fax:
Practice Address - Street 1:77 MASS AVE
Practice Address - Street 2:MEDICAL E23-395
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-4301
Practice Address - Country:US
Practice Address - Phone:617-253-1311
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA152046363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP4434OtherBLUE CROSS
Q07953Medicare UPIN
MANP4434Medicare ID - Type Unspecified