Provider Demographics
NPI:1790928398
Name:DE MEO, KAREN EHRLICH (APRN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:EHRLICH
Last Name:DE MEO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:M
Other - Last Name:EHRLICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:15 WESTOVER PKWY
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-1631
Mailing Address - Country:US
Mailing Address - Phone:781-762-2375
Mailing Address - Fax:
Practice Address - Street 1:886 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-3466
Practice Address - Country:US
Practice Address - Phone:781-769-4682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-13
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA146139363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily