Provider Demographics
NPI:1750893582
Name:BIRCH, KARA (NP)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:BIRCH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:
Other - Last Name:FTIZGERALD (MAIDEN)
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:170 DRAPER AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760-3604
Mailing Address - Country:US
Mailing Address - Phone:508-695-9421
Mailing Address - Fax:508-342-1918
Practice Address - Street 1:170 DRAPER AVE
Practice Address - Street 2:
Practice Address - City:NORTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02760-3604
Practice Address - Country:US
Practice Address - Phone:508-695-9421
Practice Address - Fax:508-342-1918
Is Sole Proprietor?:No
Enumeration Date:2017-11-02
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2287784363LF0000X
MA2287784363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner