Provider Demographics
NPI:1285045633
Name:WESTON, KAREN
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:WESTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4560 NORTH BLVD
Mailing Address - Street 2:STE 102
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-4043
Mailing Address - Country:US
Mailing Address - Phone:225-924-2484
Mailing Address - Fax:225-926-4713
Practice Address - Street 1:4560 NORTH BLVD
Practice Address - Street 2:STE 102
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-4043
Practice Address - Country:US
Practice Address - Phone:225-924-2484
Practice Address - Fax:225-926-4713
Is Sole Proprietor?:No
Enumeration Date:2014-05-19
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15045183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist