Provider Demographics
NPI:1659952265
Name:MCWHORTER, KARLA (BSN, RN)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:
Last Name:MCWHORTER
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3722 GALLOWAY ST S
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-6806
Mailing Address - Country:US
Mailing Address - Phone:217-390-6794
Mailing Address - Fax:
Practice Address - Street 1:435 LIBERTY ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3588
Practice Address - Country:US
Practice Address - Phone:503-362-3654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202010470RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse