Healthcare Provider Details

I. General information

NPI: 1881777654
Provider Name (Legal Business Name): KAREN POLLARD MURPHY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 10/28/2021
Certification Date: 10/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1075 CHASE PKWY SUITE A
WATERBURY CT
06708-2948
US

IV. Provider business mailing address

115 TOWNLINE RD SOUTH
WATERTOWN CT
06795
US

V. Phone/Fax

Practice location:
  • Phone: 203-591-3077
  • Fax:
Mailing address:
  • Phone: 860-301-1102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number6096
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: