Healthcare Provider Details

I. General information

NPI: 1407514136
Provider Name (Legal Business Name): KAREN ELIZABETH FARNSWORTH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2021
Last Update Date: 11/30/2021
Certification Date: 11/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 CANAL ST
MALDEN MA
02148-6701
US

IV. Provider business mailing address

8 ISLAND HILL AVE APT 207
MALDEN MA
02148-2645
US

V. Phone/Fax

Practice location:
  • Phone: 781-338-0055
  • Fax:
Mailing address:
  • Phone: 781-696-4224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberRN283539
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: