Provider Demographics
NPI:1548347982
Name:BORDEN, KAREN (NP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:BORDEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 LIBBEY PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02189-3129
Mailing Address - Country:US
Mailing Address - Phone:781-335-9700
Mailing Address - Fax:781-335-9709
Practice Address - Street 1:90 LIBBEY PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02189-3129
Practice Address - Country:US
Practice Address - Phone:781-335-9700
Practice Address - Fax:781-335-9709
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA194161363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP5640OtherBLUE CROSS
MANP5640OtherBLUE CROSS