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General NPI Number Information
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NPI Number | 1275511958
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Entity Type | Individual
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Provider Name | KAREN ANNE COCCOLUTO APRN BC PC
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Gender | Female
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Dates
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Enumeration Date | 01/04/2006
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Last Update Date | 05/20/2009
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Provider Practice Location Address
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Address Line | 206 STATE ST #206
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City | NORTHAMPTON
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State | MA
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Zip | 01060-2265
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Country | US
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Telephone | 413-320-7594
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Fax |
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Provider Business Mailing Address
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Address Line | 2528 MAIN POLAND RD
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City | WILLIAMSBURG
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State | MA
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Zip | 01096-9602
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Country | US
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Telephone | 413-369-4746
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 108491
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License Number State | MA
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