Provider Demographics
NPI:1497128805
Name:MCKINLEY, KAREN IRENE (LVN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:IRENE
Last Name:MCKINLEY
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4453 WOODLAWN ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77703-1947
Mailing Address - Country:US
Mailing Address - Phone:409-790-7842
Mailing Address - Fax:
Practice Address - Street 1:4453 WOODLAWN ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77703-1947
Practice Address - Country:US
Practice Address - Phone:409-790-7842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-06
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX302750164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse