Provider Demographics
NPI:1417065871
Name:WEST, KAREN (NP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:WEST
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 EAST STATE STREET
Mailing Address - Street 2:PO BOX 1250
Mailing Address - City:GLOVERSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12078
Mailing Address - Country:US
Mailing Address - Phone:518-775-4360
Mailing Address - Fax:518-773-5237
Practice Address - Street 1:99 EAST STATE STREET
Practice Address - Street 2:MAB SUITE 101
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078
Practice Address - Country:US
Practice Address - Phone:518-775-4360
Practice Address - Fax:518-773-5237
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF420519363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02329073Medicaid
NY351744OtherMVP HEALTHCARE
NYPRC200221387OtherCDPHP
NY351744OtherMVP HEALTHCARE
NYPRC200221387OtherCDPHP