Provider Demographics
NPI:1780881045
Name:BAGATELOS, KAREN CHRISTINE (MSN,NP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:CHRISTINE
Last Name:BAGATELOS
Suffix:
Gender:F
Credentials:MSN,NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 CHENERY ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94131-2907
Mailing Address - Country:US
Mailing Address - Phone:415-502-2112
Mailing Address - Fax:415-514-3300
Practice Address - Street 1:350 PARNASSUS AVE
Practice Address - Street 2:SUITE 410
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-3608
Practice Address - Country:US
Practice Address - Phone:415-502-2211
Practice Address - Fax:415-514-3300
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA461826363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner