Healthcare Provider Details

I. General information

NPI: 1508826975
Provider Name (Legal Business Name): KAREN L KUTCHERA APRN BC NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 01/14/2022
Certification Date: 01/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 COWELL FARM RD
WASHINGTON NC
27889-3431
US

IV. Provider business mailing address

1380 COWELL FARM RD
WASHINGTON NC
27889-3431
US

V. Phone/Fax

Practice location:
  • Phone: 252-946-2101
  • Fax: 252-946-9896
Mailing address:
  • Phone: 252-946-2101
  • Fax: 252-946-9896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP081869
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201650
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: