Healthcare Provider Details

I. General information

NPI: 1114068285
Provider Name (Legal Business Name): KAREEN K WORRELL D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 STEAMBOAT LANE
NEW CASTLE NH
03854-0558
US

IV. Provider business mailing address

15 STEAMBOAT LANE P.O.BOX 558
NEW CASTLE NH
03854-0558
US

V. Phone/Fax

Practice location:
  • Phone: 603-436-2260
  • Fax: 603-436-2258
Mailing address:
  • Phone: 603-436-2260
  • Fax: 603-436-2258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number7553
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: