Provider Demographics
NPI:1477090835
Name:EGGLESTON, KARI ANN (LPN)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:ANN
Last Name:EGGLESTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8230 SWEET POTATO RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45309-9667
Mailing Address - Country:US
Mailing Address - Phone:937-475-5607
Mailing Address - Fax:
Practice Address - Street 1:8230 SWEET POTATO RIDGE RD
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:OH
Practice Address - Zip Code:45309-9667
Practice Address - Country:US
Practice Address - Phone:937-475-5607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-24
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.145355.M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse