Provider Demographics
NPI:1922275353
Name:MADDY, KAREN MARIE (RN,C)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:MARIE
Last Name:MADDY
Suffix:
Gender:F
Credentials:RN,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1771 SHARWOOD PL
Mailing Address - Street 2:
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-1924
Mailing Address - Country:US
Mailing Address - Phone:410-451-0157
Mailing Address - Fax:
Practice Address - Street 1:111 PARK AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-3402
Practice Address - Country:US
Practice Address - Phone:443-909-7987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR130588163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse