=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053233536
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KEREN TERRI-ANNE JURAWAN M.D
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/28/2026
-----------------------------------------------------
Last Update Date | 07/28/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | PORT-OF-SPAIN GENERAL HOSPITAL UPPER CHARLOTTE STREET
-----------------------------------------------------
City | PORT OF SPAIN
-----------------------------------------------------
State | ST. GEORGE WEST
-----------------------------------------------------
Zip | 00000
-----------------------------------------------------
Country | TT
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 836 NELSON ROAD
-----------------------------------------------------
City | NELSON
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03457-5204
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-965-8207
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 390200000X
-----------------------------------------------------
Taxonomy Name | Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------