Healthcare Provider Details

I. General information

NPI: 1700097946
Provider Name (Legal Business Name): KAREN LYNN AZAR RNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2007
Last Update Date: 10/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 SANDERSON RD SUITE 205
SMITHFIELD RI
02917-2602
US

IV. Provider business mailing address

10 DAVOL SQ SUITE 400
PROVIDENCE RI
02903-4754
US

V. Phone/Fax

Practice location:
  • Phone: 401-349-0366
  • Fax: 401-349-4875
Mailing address:
  • Phone: 401-421-4000
  • Fax: 401-272-1456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNPP37419
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: