Provider Demographics
NPI:1790269991
Name:KEARNEY, KAREN ISABEL (RN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ISABEL
Last Name:KEARNEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:ISABEL
Other - Last Name:KEARNEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:1614 SAN FRANCISCO ST
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-5048
Mailing Address - Country:US
Mailing Address - Phone:214-205-3335
Mailing Address - Fax:
Practice Address - Street 1:1614 SAN FRANCISCO ST
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-5048
Practice Address - Country:US
Practice Address - Phone:214-205-3335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX447561163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse