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General NPI Number Information
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NPI Number | 1851174312
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Entity Type | Individual
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Provider Name | KAREN KAY NAMBO RN
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Gender | Female
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Dates
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Enumeration Date | 08/17/2023
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Last Update Date | 08/29/2023
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Provider Practice Location Address
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Address Line | 215 EASTON PKWY
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City | ROCKFORD
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State | IL
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Zip | 61108-2216
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Country | US
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Telephone | 815-962-0871
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Fax | 815-962-7895
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Provider Business Mailing Address
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Address Line | 215 EASTON PKWY
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City | ROCKFORD
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State | IL
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Zip | 61108-2216
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Country | US
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Telephone | 815-962-0871
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Fax | 815-962-7895
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041368248
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License Number State | IL
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