Provider Demographics
NPI:1790902682
Name:STUECKLEN, KAREN R (RN)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:R
Last Name:STUECKLEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:R
Other - Last Name:KALISH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:1331 MANN HILL RD
Mailing Address - Street 2:
Mailing Address - City:POWNAL
Mailing Address - State:VT
Mailing Address - Zip Code:05261-9496
Mailing Address - Country:US
Mailing Address - Phone:802-823-5155
Mailing Address - Fax:
Practice Address - Street 1:25 MAIN STREET
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01262
Practice Address - Country:US
Practice Address - Phone:413-931-5320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA218132163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health