Provider Demographics
NPI:1295496628
Name:O'GILVIE, KARMOLETTE (RN)
Entity type:Individual
Prefix:
First Name:KARMOLETTE
Middle Name:
Last Name:O'GILVIE
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 1:6530 LA CONTENTA RD STE 100
Mailing Address - Street 2:
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92284-7313
Mailing Address - Country:US
Mailing Address - Phone:760-365-9305
Mailing Address - Fax:
Practice Address - Street 1:6530 LA CONTENTA RD STE 100
Practice Address - Street 2:
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-7313
Practice Address - Country:US
Practice Address - Phone:760-365-9305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-07
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA552906163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator