Basic Information
Provider Information
NPI: 1548493778
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WU
FirstName: KAREN
MiddleName: S
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 804 SCOTT NIXON MEMORIAL DR
Address2:  
City: AUGUSTA
State: GA
PostalCode: 309072464
CountryCode: US
TelephoneNumber: 8003944445
FaxNumber: 7066501034
Practice Location
Address1: 24 STEVENS ST
Address2:  
City: NORWALK
State: CT
PostalCode: 068503852
CountryCode: US
TelephoneNumber: 2038522000
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/04/2009
LastUpdateDate: 09/04/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X4170CTY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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