Provider Demographics
NPI: | 1376049379 |
---|---|
Name: | FRADE, KARA E (CNP) |
Entity type: | Individual |
Prefix: | |
First Name: | KARA |
Middle Name: | E |
Last Name: | FRADE |
Suffix: | |
Gender: | F |
Credentials: | CNP |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 200 MILL RD |
Mailing Address - Street 2: | |
Mailing Address - City: | FAIRHAVEN |
Mailing Address - State: | MA |
Mailing Address - Zip Code: | 02719-5252 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 508-973-2000 |
Mailing Address - Fax: | 508-973-2001 |
Practice Address - Street 1: | 543 NORTH ST |
Practice Address - Street 2: | |
Practice Address - City: | NEW BEDFORD |
Practice Address - State: | MA |
Practice Address - Zip Code: | 02740-2782 |
Practice Address - Country: | US |
Practice Address - Phone: | 508-973-2208 |
Practice Address - Fax: | 508-973-1225 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2018-03-30 |
Last Update Date: | 2025-01-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MA | RN2282998 | 363L00000X, 367A00000X |
MA | 2282998 | 363LA2100X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 367A00000X | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife | |
No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | |
No | 363LA2100X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |