Provider Demographics
NPI:1639219819
Name:CARR, KAREN (CPM)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:
Last Name:CARR
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 KENTUCKY AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21213-1012
Mailing Address - Country:US
Mailing Address - Phone:410-467-4586
Mailing Address - Fax:410-467-0506
Practice Address - Street 1:2222 KENTUCKY AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-1012
Practice Address - Country:US
Practice Address - Phone:410-467-4586
Practice Address - Fax:410-467-0506
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP43258Medicare UPIN