Provider Demographics
NPI:1649985201
Name:HERRIGAN, KAREN DORETHA (LVN II)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:DORETHA
Last Name:HERRIGAN
Suffix:
Gender:F
Credentials:LVN II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1807 E 120TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90059-3005
Mailing Address - Country:US
Mailing Address - Phone:424-338-2948
Mailing Address - Fax:310-631-2934
Practice Address - Street 1:1807 E 120TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90059-3005
Practice Address - Country:US
Practice Address - Phone:424-338-2948
Practice Address - Fax:310-631-2934
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-18
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN183809164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse