Provider Demographics
NPI:1306024013
Name:MCCREA, KAREN L (FNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:L
Last Name:MCCREA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1250
Mailing Address - Street 2:
Mailing Address - City:GLOVERSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12078-0010
Mailing Address - Country:US
Mailing Address - Phone:518-775-4201
Mailing Address - Fax:518-775-4225
Practice Address - Street 1:99 EAST STATE STREET
Practice Address - Street 2:MAB SUITE G01
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078-1203
Practice Address - Country:US
Practice Address - Phone:518-775-4201
Practice Address - Fax:518-775-4225
Is Sole Proprietor?:No
Enumeration Date:2008-02-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF 334611363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY435254-1OtherLICENSE
NY435254-1OtherLICENSE