Healthcare Provider Details

I. General information

NPI: 1306870191
Provider Name (Legal Business Name): KAREN M HURD CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1423 CHAPEL STREET
NEW HAREN CT
06511
US

IV. Provider business mailing address

375 ISINGLASS RD
SHELTON CT
06484
US

V. Phone/Fax

Practice location:
  • Phone: 203-789-3538
  • Fax: 203-865-2983
Mailing address:
  • Phone: 203-944-0316
  • Fax: 203-929-5135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number46000
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: