Provider Demographics
NPI:1437757192
Name:THEOLOGIS, KARI LEIGH (RN)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:LEIGH
Last Name:THEOLOGIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:LEIGH
Other - Last Name:EASLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:670 ROUTE 1 N
Mailing Address - Street 2:
Mailing Address - City:ISELIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08830-2629
Mailing Address - Country:US
Mailing Address - Phone:732-510-1147
Mailing Address - Fax:
Practice Address - Street 1:670 ROUTE 1 N
Practice Address - Street 2:
Practice Address - City:ISELIN
Practice Address - State:NJ
Practice Address - Zip Code:08830-2629
Practice Address - Country:US
Practice Address - Phone:732-510-1147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR18079000163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse