Provider Demographics
NPI:1891591939
Name:VAGHEFI, KAREN JOSEPHINE
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:JOSEPHINE
Last Name:VAGHEFI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6070 KENTONS LN
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-8464
Mailing Address - Country:US
Mailing Address - Phone:678-891-8673
Mailing Address - Fax:
Practice Address - Street 1:6070 KENTONS LN
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-8464
Practice Address - Country:US
Practice Address - Phone:678-891-8673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN220000163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator