Provider Demographics
NPI:1255407904
Name:TRAVERS, KAREN BETH (RD)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:BETH
Last Name:TRAVERS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MISS
Other - First Name:KAREN
Other - Middle Name:BETH
Other - Last Name:SAKKINEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1854 DIAMOND HILL RD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-5530
Mailing Address - Country:US
Mailing Address - Phone:401-334-0801
Mailing Address - Fax:
Practice Address - Street 1:211 PARK ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-3143
Practice Address - Country:US
Practice Address - Phone:508-236-8033
Practice Address - Fax:508-236-8031
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2086133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
RILDN00278OtherOTHER
MATRMT0560Medicare ID - Type Unspecified