Provider Demographics
NPI:1326383415
Name:SMITH, KAREN ALICE (RN)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ALICE
Last Name:SMITH
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 1:105 7TH ST SW
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98371-5333
Mailing Address - Country:US
Mailing Address - Phone:253-841-8711
Mailing Address - Fax:253-435-6509
Practice Address - Street 1:105 7TH ST SW
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98371-5333
Practice Address - Country:US
Practice Address - Phone:253-841-8711
Practice Address - Fax:253-435-6509
Is Sole Proprietor?:No
Enumeration Date:2012-11-30
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00101242163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool