Provider Demographics
NPI:1467541243
Name:MCGUINESS, KAREN (APRN)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:MCGUINESS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:JASDEEP
Other - Middle Name:KAUR
Other - Last Name:KHALSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:PO BOX 4131
Mailing Address - Street 2:
Mailing Address - City:YALESVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06492-1481
Mailing Address - Country:US
Mailing Address - Phone:203-284-1340
Mailing Address - Fax:203-265-4557
Practice Address - Street 1:435 LEWIS AVE
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06451-2101
Practice Address - Country:US
Practice Address - Phone:203-284-1340
Practice Address - Fax:203-265-4557
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001084363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
Provider Identifiers
StateIdentifier IDID TypeIssuer
P29567Medicare UPIN