Provider Demographics
NPI:1811903636
Name:TYSZKOWSKI, KAREN ANNE (RNCNS)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:ANNE
Last Name:TYSZKOWSKI
Suffix:
Gender:F
Credentials:RNCNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 TEN ROD ROAD
Mailing Address - Street 2:SUITE E204
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852
Mailing Address - Country:US
Mailing Address - Phone:401-294-9600
Mailing Address - Fax:401-295-7395
Practice Address - Street 1:1130 TEN ROD ROAD
Practice Address - Street 2:SUITE E204
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852
Practice Address - Country:US
Practice Address - Phone:401-294-9600
Practice Address - Fax:401-295-7395
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN11331163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000003469001OtherBLUE CROSS
RI00406295001OtherBLUE CHIP CP
RI1023160OtherBEACON
RI370170OtherMAGELLAN UNITED HC
RI00406295001OtherBLUE CHIP CP