Provider Demographics
NPI:1811986748
Name:KOVACS, KAREN M (NP)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:M
Last Name:KOVACS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:545 BEDFORD ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02324-3117
Mailing Address - Country:US
Mailing Address - Phone:508-697-3677
Mailing Address - Fax:508-697-9396
Practice Address - Street 1:545 BEDFORD ST
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02324-3117
Practice Address - Country:US
Practice Address - Phone:508-697-3677
Practice Address - Fax:508-894-9396
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL309-002004363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL17123Medicare UPIN