Provider Demographics
NPI:1508084146
Name:HARRISON, KAREN CHARLENE (R N)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:CHARLENE
Last Name:HARRISON
Suffix:
Gender:F
Credentials:R N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 VIA POUDRE
Mailing Address - Street 2:
Mailing Address - City:SAN LORENZO
Mailing Address - State:CA
Mailing Address - Zip Code:94580-3012
Mailing Address - Country:US
Mailing Address - Phone:510-535-4400
Mailing Address - Fax:510-261-6438
Practice Address - Street 1:3124 INTERNATIONAL BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94601-2902
Practice Address - Country:US
Practice Address - Phone:510-535-4400
Practice Address - Fax:510-261-6438
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA456807163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator