Individual
KAREN J LOGULLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
701 N CLAYTON ST, 3RD FLOOR, WILMINGTON, DE 19805-3518
(302) 421-4330
(302) 421-4331
Mailing address
PO BOX 650782, DALLAS, TX 75265-0782
(302) 733-0806
(302) 733-0854
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
26NJ00366200
NJ
367500000X
Certified Registered Nurse Anesthetist
Primary
L6-0A00631
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
088734
AANA NUMBER
DE
01
—
26NR15462900
RN LICENSE
NJ
01
—
L1-0033257
RN LICENSE
DE
Enumeration date
03/01/2012
Last updated
07/09/2012
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