Provider Demographics
NPI:1467140178
Name:NAMAKA-FOOTE, KAREN LYNN (RN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:LYNN
Last Name:NAMAKA-FOOTE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:LYNN
Other - Last Name:NAMAKA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:5599 SOUTHERN WINDS DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38002-4493
Mailing Address - Country:US
Mailing Address - Phone:901-900-4880
Mailing Address - Fax:
Practice Address - Street 1:1030 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-2127
Practice Address - Country:US
Practice Address - Phone:901-523-8990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN88729163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty