Provider Demographics
NPI:1487887923
Name:WALDEN, KARLA J (LPN)
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:J
Last Name:WALDEN
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 1:1100 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:TN
Mailing Address - Zip Code:38551-4243
Mailing Address - Country:US
Mailing Address - Phone:931-243-2651
Mailing Address - Fax:
Practice Address - Street 1:115 GUFFEY ST
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:TN
Practice Address - Zip Code:38551-4089
Practice Address - Country:US
Practice Address - Phone:931-243-2651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN62666164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse