Healthcare Provider Details

I. General information

NPI: 1427368752
Provider Name (Legal Business Name): KAREN V DUHAMEL R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2010
Last Update Date: 10/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

189 STORRS RD
MANSFIELD CENTER CT
06250-1683
US

IV. Provider business mailing address

330 WOODLAND RD
COVENTRY CT
06238-2335
US

V. Phone/Fax

Practice location:
  • Phone: 860-456-1311
  • Fax:
Mailing address:
  • Phone: 860-742-1409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberE54159
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: