Provider Demographics
NPI:1679699136
Name:DAHLGARD, KAREN JANE (MSN, CS, APRN)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:JANE
Last Name:DAHLGARD
Suffix:
Gender:F
Credentials:MSN, CS, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:832 TALL TIMBER RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477
Mailing Address - Country:US
Mailing Address - Phone:203-387-8425
Mailing Address - Fax:203-392-3564
Practice Address - Street 1:832 TALL TIMBER RD
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477
Practice Address - Country:US
Practice Address - Phone:203-387-8425
Practice Address - Fax:203-392-3564
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000918363LP0808X
CTE33853163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse