Healthcare Provider Details

I. General information

NPI: 1932183837
Provider Name (Legal Business Name): KAREN ANN PEARSON MSN, NURSE PRACTITIO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 TERESA DR
MORRO BAY CA
93442-2458
US

IV. Provider business mailing address

PO BOX 487
CAMBRIA CA
93428-0487
US

V. Phone/Fax

Practice location:
  • Phone: 805-772-2237
  • Fax:
Mailing address:
  • Phone: 805-305-5176
  • Fax: 805-927-4910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN225919
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: