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NPI Code Detail

MEDICARE: MS. KAREN LOUISE DEVEREUX LPN

MEDICARE: MS. KAREN LOUISE DEVEREUX LPN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical NurseLP00032147WA

General Provider Information

NPI Number : 1144401209
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KAREN LOUISE DEVEREUX LPN
Provider Business Mailing Address
First Line : 5509 N 41ST ST
Second Line :
City : TACOMA
State : WA
Zip : 98407-3607
Country : US
Telephone Number : 253-606-5162
Fax Number :
Provider Business Practice Location Address
First Line : 610 YAKIMA AVE
Second Line :
City : TACOMA
State : WA
Zip : 98405-4851
Country : US
Telephone Number : 253-606-5162
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2007
Last Update Date : 11/16/2007

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