Provider Demographics
NPI:1740509538
Name:MATHEWS, KAREN L (NP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:L
Last Name:MATHEWS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:L
Other - Last Name:ANDREWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:333 ELM STREET
Mailing Address - Street 2:SUITE 220
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-2954
Mailing Address - Country:US
Mailing Address - Phone:781-329-7311
Mailing Address - Fax:781-461-9224
Practice Address - Street 1:333 ELM STREET
Practice Address - Street 2:SUITE 220
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-2954
Practice Address - Country:US
Practice Address - Phone:781-329-7311
Practice Address - Fax:781-461-9224
Is Sole Proprietor?:No
Enumeration Date:2010-05-19
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN186135363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP091401Medicare PIN