Provider Demographics
NPI:1194790758
Name:FLEMING, KAREN M (NP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:FLEMING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5 NEPONSET ST FL ST2
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-2714
Mailing Address - Country:US
Mailing Address - Phone:508-368-5532
Mailing Address - Fax:508-832-0859
Practice Address - Street 1:385 SOUTHBRIDGE ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MA
Practice Address - Zip Code:01501-2498
Practice Address - Country:US
Practice Address - Phone:508-721-1170
Practice Address - Fax:508-832-0859
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN165966363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NP0901OtherMEDICARE B
042472266OtherRAILROAD MEDICARE
8301288OtherEVERCARE
NP0901OtherBLUE SHIELD HMO BLUE
0343960OtherMEDICAID WELFARE
042472266OtherPRIVATE HEALTHCARE SYSTEM
AA3631OtherHARVARD PILGRIM HEALTHCAR
MA0343960Medicaid
NP0901OtherBLUE CARE ELECT
NP0901OtherBLUE SHIELD INDEMNITY
042472266OtherTHREE RIVERS
381316OtherMVP HEALTH CARE
57180OtherFALLON COMMUNITY HEALTH P
NP0901OtherBLUE SHIELD INDEMNITY