Provider Demographics
NPI:1043353881
Name:HABIN, KARLEEN R (RN)
Entity type:Individual
Prefix:
First Name:KARLEEN
Middle Name:R
Last Name:HABIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 223
Mailing Address - Street 2:90 WOOD STREET
Mailing Address - City:JEFFERSON
Mailing Address - State:MA
Mailing Address - Zip Code:01522-0223
Mailing Address - Country:US
Mailing Address - Phone:508-829-5366
Mailing Address - Fax:
Practice Address - Street 1:32 FRUIT ST
Practice Address - Street 2:YAWKEY 9A ROOM 9746
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2620
Practice Address - Country:US
Practice Address - Phone:617-726-1922
Practice Address - Fax:617-724-1079
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA160051163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0200XNursing Service ProvidersRegistered NurseOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA81532Medicare UPIN