MEDICARE: KAREN MARIE MATHER APN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	LP-0000360	DE

General Provider Information

NPI Number	:	1285250118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN MARIE MATHER APN

Provider Business Mailing Address
First Line	:	33188 COASTAL HWY UNIT 4
Second Line	:
City	:	BETHANY BEACH
State	:	DE
Zip	:	19930-3779
Country	:	US
Telephone Number	:	302-537-1100
Fax Number	:

Provider Business Practice Location Address
First Line	:	33188 COASTAL HWY UNIT 4
Second Line	:
City	:	BETHANY BEACH
State	:	DE
Zip	:	19930-3779
Country	:	US
Telephone Number	:	302-537-1100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2020
Last Update Date	:	06/16/2020

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