Provider Demographics
NPI:1508826975
Name:KUTCHERA, KAREN L (APRN BC NP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:L
Last Name:KUTCHERA
Suffix:
Gender:F
Credentials:APRN BC NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 COWELL FARM RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889-3431
Mailing Address - Country:US
Mailing Address - Phone:252-946-2101
Mailing Address - Fax:252-946-9896
Practice Address - Street 1:1380 COWELL FARM RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-3431
Practice Address - Country:US
Practice Address - Phone:252-946-2101
Practice Address - Fax:252-946-9896
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAP081869363LF0000X
NC201650363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME433261199Medicaid
P76822Medicare UPIN