Provider Demographics
NPI:1346210689
Name:HIEKEN, KAREN M (PA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:HIEKEN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 CHIEF JUSTICE CUSHING HWY STE 1A
Mailing Address - Street 2:
Mailing Address - City:COHASSET
Mailing Address - State:MA
Mailing Address - Zip Code:02025-2124
Mailing Address - Country:US
Mailing Address - Phone:781-247-5500
Mailing Address - Fax:781-247-5215
Practice Address - Street 1:760 CHIEF JUSTICE CUSHING HWY STE 1A
Practice Address - Street 2:
Practice Address - City:COHASSET
Practice Address - State:MA
Practice Address - Zip Code:02025-2124
Practice Address - Country:US
Practice Address - Phone:781-247-5500
Practice Address - Fax:781-246-5215
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1491363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q27308Medicare UPIN
AP2255Medicare ID - Type Unspecified