Provider Demographics
NPI:1477527224
Name:PARKHURST, KAREN R (APRN)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:R
Last Name:PARKHURST
Suffix:
Gender:F
Credentials:APRN
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Mailing Address - Street 1:1625 STRAITS TPKE
Mailing Address - Street 2:SUITE #201
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762-1805
Mailing Address - Country:US
Mailing Address - Phone:203-573-9512
Mailing Address - Fax:203-568-2904
Practice Address - Street 1:140 GRANDVIEW AVE
Practice Address - Street 2:SUITE #101
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-2505
Practice Address - Country:US
Practice Address - Phone:203-573-7284
Practice Address - Fax:203-573-7031
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2011-02-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CTE54317163W00000X
CT000825363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004207868Medicaid
P15249Medicare UPIN
CT004207868Medicaid