Basic Information
| Provider Information | |||||||||
| NPI: | 1982849378 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BORM | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16873 HUMMINGBIRD LN | ||||||||
| Address2: | |||||||||
| City: | COTTONWOOD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960229691 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5305278224 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1860 WALNUT ST | ||||||||
| Address2: | |||||||||
| City: | RED BLUFF | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960803611 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5305275637 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/13/2008 | ||||||||
| LastUpdateDate: | 12/13/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WC0400X | 675909 | CA | N | Nursing Service Providers | Registered Nurse | Case Management | 163WH1000X | 675909 | CA | N | Nursing Service Providers | Registered Nurse | Hospice | 163WM0705X | 675909 | CA | Y | Nursing Service Providers | Registered Nurse | Medical-Surgical | 163WP0808X | 675909 | CA | N | Nursing Service Providers | Registered Nurse | Psych/Mental Health |
No ID Information.