Provider Demographics
NPI:1124076245
Name:SECORE, KAREN LOUISE (APRN)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:LOUISE
Last Name:SECORE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:LOUISE
Other - Last Name:GILBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:400 W PUEBLO ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-4390
Mailing Address - Country:US
Mailing Address - Phone:805-832-3633
Mailing Address - Fax:
Practice Address - Street 1:400 W PUEBLO ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-4353
Practice Address - Country:US
Practice Address - Phone:805-832-3633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH032481-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0NP2173Medicaid
NH30340684Medicaid
NHNP217301Medicare PIN
NH30340684Medicaid
NHNP2173Medicare PIN