Provider Demographics
NPI:1881887982
Name:MADDEN, KAREN WHEELER (NP, BC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:WHEELER
Last Name:MADDEN
Suffix:
Gender:F
Credentials:NP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 RANDOLPH ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-2351
Mailing Address - Country:US
Mailing Address - Phone:781-830-8419
Mailing Address - Fax:781-830-8403
Practice Address - Street 1:3 RANDOLPH ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-2351
Practice Address - Country:US
Practice Address - Phone:781-830-8419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA174567363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics