Healthcare Provider Details

I. General information

NPI: 1578073128
Provider Name (Legal Business Name): KAREN CARREIRO FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2017
Last Update Date: 06/30/2020
Certification Date: 06/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

775 DAVOL ST STE 3
FALL RIVER MA
02720-1028
US

IV. Provider business mailing address

775 DAVOL ST STE 3
FALL RIVER MA
02720-1028
US

V. Phone/Fax

Practice location:
  • Phone: 508-674-4000
  • Fax: 508-674-8880
Mailing address:
  • Phone: 508-674-4000
  • Fax: 508-674-8880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN01710
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License NumberRN285354
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: