Provider Demographics
NPI:1508452350
Name:SLONE, KARENINA MARIE (RN)
Entity Type:Individual
Prefix:
First Name:KARENINA
Middle Name:MARIE
Last Name:SLONE
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 1:305 BARBER CREEK RD
Mailing Address - Street 2:
Mailing Address - City:PORT BYRON
Mailing Address - State:IL
Mailing Address - Zip Code:61275-9200
Mailing Address - Country:US
Mailing Address - Phone:563-340-4444
Mailing Address - Fax:
Practice Address - Street 1:305 BARBER CREEK RD
Practice Address - Street 2:
Practice Address - City:PORT BYRON
Practice Address - State:IL
Practice Address - Zip Code:61275-9200
Practice Address - Country:US
Practice Address - Phone:563-340-4444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.406182163WM0705X
IA110201163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical