Provider Demographics
NPI:1982849378
Name:BORM, KAREN A (RN)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:A
Last Name:BORM
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 1:16873 HUMMINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:96022-9691
Mailing Address - Country:US
Mailing Address - Phone:530-527-8224
Mailing Address - Fax:
Practice Address - Street 1:1860 WALNUT ST
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-3611
Practice Address - Country:US
Practice Address - Phone:530-527-5637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-13
Last Update Date:2008-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA675909163WC0400X, 163WH1000X, 163WM0705X, 163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health