Provider Demographics
NPI:1881675528
Name:MANEY, KAREN (NP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:MANEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 87
Mailing Address - Street 2:
Mailing Address - City:WEST HARWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02671-0087
Mailing Address - Country:US
Mailing Address - Phone:774-237-9116
Mailing Address - Fax:774-237-3411
Practice Address - Street 1:55 CLEARWATER DR
Practice Address - Street 2:
Practice Address - City:HARWICH
Practice Address - State:MA
Practice Address - Zip Code:02645-2901
Practice Address - Country:US
Practice Address - Phone:774-237-9116
Practice Address - Fax:978-354-4651
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA176671363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP1042OtherBLUE CROSS
MA0351130Medicaid
MA0351130Medicaid
S55229Medicare UPIN