Provider Demographics
NPI:1023330362
Name:KAWA, KAREN (ANP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:KAWA
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 VICTORIA LN
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02048-1755
Mailing Address - Country:US
Mailing Address - Phone:508-944-7189
Mailing Address - Fax:
Practice Address - Street 1:ONE CUNNINGHAM SQUARE DAVIS HALL
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02918-1430
Practice Address - Country:US
Practice Address - Phone:401-865-2422
Practice Address - Fax:401-865-2809
Is Sole Proprietor?:No
Enumeration Date:2010-02-26
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RINPP33985363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI1023330362Medicaid
RIS66200Medicare UPIN