Provider Demographics
NPI:1083622302
Name:MAHAN, KARI LAURAYNE (RN)
Entity Type:Individual
Prefix:MS
First Name:KARI
Middle Name:LAURAYNE
Last Name:MAHAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:KARI
Other - Middle Name:SCOTT
Other - Last Name:MAHAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:231 ASPENWAY DR
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-5506
Mailing Address - Country:US
Mailing Address - Phone:972-741-1824
Mailing Address - Fax:
Practice Address - Street 1:12655 N CENTRAL EXPY STE 650
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-1770
Practice Address - Country:US
Practice Address - Phone:214-688-0078
Practice Address - Fax:214-688-0359
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX248161163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse