Provider Demographics
NPI:1477382414
Name:WILLETT, KAREN (LPN)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:
Last Name:WILLETT
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 1:9300 DEWITT LOOP
Mailing Address - Street 2:
Mailing Address - City:FT BELVOIR
Mailing Address - State:VA
Mailing Address - Zip Code:22060-5285
Mailing Address - Country:US
Mailing Address - Phone:571-231-1402
Mailing Address - Fax:
Practice Address - Street 1:7655 MARSHALL CORNER RD
Practice Address - Street 2:
Practice Address - City:POMFRET
Practice Address - State:MD
Practice Address - Zip Code:20675-3050
Practice Address - Country:US
Practice Address - Phone:240-304-4615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VALP31379164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse