Provider Demographics
NPI:1275838294
Name:FORKNOT, KAREN KAY-ANN (RN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:KAY-ANN
Last Name:FORKNOT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 SYNOTT RD APT 1009
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-3549
Mailing Address - Country:US
Mailing Address - Phone:832-289-1081
Mailing Address - Fax:
Practice Address - Street 1:2727 SYNOTT RD APT 1009
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-3549
Practice Address - Country:US
Practice Address - Phone:832-289-1081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-23
Last Update Date:2011-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX763114163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics