Katrina Marie Avery, R.N

Individual provider Active NPI Registered Nurse · Carson, CA

NPI 1407064884 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1407064884
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
461812 (CA)
Practice address
1875 E Fernrock St
Carson, CA 90746-2538
Phone
(310) 924-1002
Fax
(310) 632-0356
NPI assigned
May 18, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
461812CAMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 461812 CA Yes

Addresses

Primary practice location

1875 E Fernrock St
Carson, CA 90746-2538

Mailing address

1875 E Fernrock St
Carson, CA 90746-2538
Phone (310) 924-1002

Other providers in Carson, CA

All providers in Carson, CA · Registered Nurse in California

Sources for this page

Verify at the official NPI Registry.