Healthcare Provider Details

I. General information

NPI: 1750446852
Provider Name (Legal Business Name): KAREN ANN CLAISE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 HATCHETTS HILL RD
OLD LYME CT
06371-1534
US

IV. Provider business mailing address

55 HATCHETTS HILL RD
OLD LYME CT
06371-1534
US

V. Phone/Fax

Practice location:
  • Phone: 800-370-3651
  • Fax: 410-832-5783
Mailing address:
  • Phone: 800-370-3651
  • Fax: 410-832-5783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number9300187
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number26NJ00501300
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number71002457A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: