Provider Demographics
NPI:1841236718
Name:MCDONALD, KAREN (PCNS)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:PCNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1351 S COUNTY TRL
Mailing Address - Street 2:BUILDING 2 SUITE 210
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-5079
Mailing Address - Country:US
Mailing Address - Phone:401-884-2008
Mailing Address - Fax:401-884-2075
Practice Address - Street 1:1351 S COUNTY TRL
Practice Address - Street 2:BUILDING 2 SUITE 210
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-5079
Practice Address - Country:US
Practice Address - Phone:401-884-2008
Practice Address - Fax:401-884-2075
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-21
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPPNS00029163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI30450-2OtherBLUE CROSS & BLUE SHIELD
RI407855OtherCOORDINATED HEALTH PLANS
RI05-0468084OtherUNITED HEALTH PLANS
RI05-0468084OtherUNITED HEALTH PLANS