Provider Demographics
NPI:1649521576
Name:HARRIS-ANDERSON, KARREN KEISHA (LPN)
Entity type:Individual
Prefix:MRS
First Name:KARREN
Middle Name:KEISHA
Last Name:HARRIS-ANDERSON
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 1:2936 HIDDEN HILLS RD
Mailing Address - Street 2:1505
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-4826
Mailing Address - Country:US
Mailing Address - Phone:561-506-7070
Mailing Address - Fax:
Practice Address - Street 1:2215 N MILITARY TRL
Practice Address - Street 2:SUITE A
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-2972
Practice Address - Country:US
Practice Address - Phone:561-506-7070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5179825164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse