Provider Demographics
NPI:1720381676
Name:DAVIS, KAREN M (RN)
Entity Type:Individual
Prefix:MISS
First Name:KAREN
Middle Name:M
Last Name:DAVIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 RANDLETT PL
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02125-3027
Mailing Address - Country:US
Mailing Address - Phone:617-442-1649
Mailing Address - Fax:
Practice Address - Street 1:3 RANDLETT PL
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02125-3027
Practice Address - Country:US
Practice Address - Phone:617-442-1649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-15
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA272242163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse