Provider Demographics
NPI:1770180499
Name:PACHECO, KAREN CHRISTINE (NP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:CHRISTINE
Last Name:PACHECO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:CHRISTINE
Other - Last Name:REYES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:455 TOLL GATE RD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-2759
Mailing Address - Country:US
Mailing Address - Phone:401-273-0641
Mailing Address - Fax:401-273-2919
Practice Address - Street 1:1220 PONTIAC AVE STE 101
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-4455
Practice Address - Country:US
Practice Address - Phone:401-943-4660
Practice Address - Fax:401-943-0240
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN02437207R00000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine