Provider Demographics
NPI:1528715471
Name:CHICCO, KAREN M X (LICENSED NURSE)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:M
Last Name:CHICCO
Suffix:X
Gender:F
Credentials:LICENSED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 LEWIS DRIVE
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-2418
Mailing Address - Country:US
Mailing Address - Phone:617-930-4544
Mailing Address - Fax:
Practice Address - Street 1:28 LEWIS DR
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-2418
Practice Address - Country:US
Practice Address - Phone:617-930-4544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN93999164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse