Provider Demographics
NPI:1285931659
Name:VERNON, KARI (DC)
Entity type:Individual
Prefix:DR
First Name:KARI
Middle Name:
Last Name:VERNON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 W ONTARIO ST
Mailing Address - Street 2:
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-8349
Mailing Address - Country:US
Mailing Address - Phone:480-905-1883
Mailing Address - Fax:
Practice Address - Street 1:18777 N 32ND ST STE 80
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050-3202
Practice Address - Country:US
Practice Address - Phone:480-905-1883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-22
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4436111NN1001X
AZ171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
No171100000XOther Service ProvidersAcupuncturist