Provider Demographics
NPI:1447238332
Name:PINKHAM, KAREN A (CRNA)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:PINKHAM
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:A
Other - Last Name:METIVIER-RILEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:272 STANLEY ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-6009
Mailing Address - Country:US
Mailing Address - Phone:508-672-2290
Mailing Address - Fax:508-679-3766
Practice Address - Street 1:272 STANLEY ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-6009
Practice Address - Country:US
Practice Address - Phone:508-672-2290
Practice Address - Fax:508-679-3766
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN00211367500000X
MA202048367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANA0774Medicare PIN
RI007057278Medicare PIN