Basic Information
Provider Information | |||||||||
NPI: | 1295229615 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | CUMMINS | ||||||||
FirstName: | KAREN | ||||||||
MiddleName: | B | ||||||||
NamePrefix: | MS. | ||||||||
NameSuffix: |   | ||||||||
Credential: | NP | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | BARTON | ||||||||
OtherFirstName: | KAREN | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 15 HOSPITAL DR | ||||||||
Address2: |   | ||||||||
City: | YORK | ||||||||
State: | ME | ||||||||
PostalCode: | 039091099 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2073512478 | ||||||||
FaxNumber: | 2073512216 | ||||||||
Practice Location | |||||||||
Address1: | 16 HOSPITAL DR | ||||||||
Address2: |   | ||||||||
City: | YORK | ||||||||
State: | ME | ||||||||
PostalCode: | 039091011 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2073513455 | ||||||||
FaxNumber: | 2073541346 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/19/2018 | ||||||||
LastUpdateDate: | 06/19/2018 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | CNP40273 | ME | Y |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |   |
No ID Information.