Provider Demographics
NPI:1285250118
Name:MATHER, KAREN MARIE (APN)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:MARIE
Last Name:MATHER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33188 COASTAL HWY UNIT 4
Mailing Address - Street 2:
Mailing Address - City:BETHANY BEACH
Mailing Address - State:DE
Mailing Address - Zip Code:19930-3779
Mailing Address - Country:US
Mailing Address - Phone:302-537-1100
Mailing Address - Fax:
Practice Address - Street 1:33188 COASTAL HWY UNIT 4
Practice Address - Street 2:
Practice Address - City:BETHANY BEACH
Practice Address - State:DE
Practice Address - Zip Code:19930-3779
Practice Address - Country:US
Practice Address - Phone:302-537-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-16
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELP-0000360363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner