KEVIN G PICKENS APRN (Credential# 591662) is licensed (Registered Nurse) with Connecticut Department of Consumer Protection. The license effective date is August 1, 2012. The license expiration date date is July 31, 2013. The license status is INACTIVE.
KEVIN G PICKENS APRN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #10.087660. The credential type is registered nurse. The effective date is August 1, 2012. The expiration date is July 31, 2013. The business address is 5225 Thunder Dr, Ammon, ID 83406. The current status is inactive.
Licensee Name | KEVIN G PICKENS APRN |
Credential ID | 591662 |
Credential Number | 10.087660 |
Credential Type | Registered Nurse |
Business Address |
5225 Thunder Dr Ammon ID 83406 |
Business Type | INDIVIDUAL |
Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
Issue Date | 2009-01-08 |
Effective Date | 2012-08-01 |
Expiration Date | 2013-07-31 |
Refresh Date | 2013-11-06 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
682183 | 12.004005 | Advanced Practice Registered Nurse | 2009-01-08 | 2012-08-01 - 2013-07-31 | INACTIVE |
523453 | CSP.0045031 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2009-01-26 | 2011-03-01 - 2013-02-28 | INACTIVE |
Street Address | 5225 Thunder Dr |
City | Ammon |
State | ID |
Zip Code | 83406 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Luisa A Hiendlmayr | 5911 Loon Creek Ln, Idaho Falls, ID 83406 | Physician/surgeon | 2019-06-01 ~ 2020-05-31 |
Susan D Dunnells | 5279 Barton Pl, Ammon, ID 83406 | Licensed Practical Nurse | 2008-10-06 ~ 2009-11-30 |
Aaron O Buffardi | 3669 Ellendale Circle, Idaho Falls, ID 83406 | Physical Therapist | 2007-10-31 ~ 2008-12-31 |
Christopher Alan Lee | 3040 Devonwood Dr, Ammon, ID 83406-4700 | Registered Nurse | 2018-10-01 ~ 2019-09-30 |
James Fraser | 3929 Schwieder Ln, Idaho Falls, ID 83406-8106 | Radiographer | 2012-04-03 ~ 2012-07-31 |
City | Ammon |
Zip Code | 83406 |
License Type | Registered Nurse |
License Type + County | Registered Nurse + Ammon |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Kooin K Hyun Aprn | 6 Kevin Drive, Danbury, CT 06811 | Advanced Practice Registered Nurse | 2001-01-17 ~ 2002-03-31 |
Mary D Carroccia | 17 Pickens Drive, Newington, CT 06111 | Registered Nurse | 2000-05-16 ~ 2009-08-31 |
Sasha M Pickens | 9915 E Decatur St, Mesa, AZ 85207-6225 | Registered Nurse | 2014-10-01 ~ 2015-09-30 |
Gloria A Pickens | 915 Madison Street, Little Rock, AR 72204 | Registered Nurse | 2001-10-24 ~ 2002-05-31 |
Jean H Pickens | 3 Poplar Hill Dr, Farmington, CT 06032 | Registered Nurse | 2020-02-01 ~ 2021-01-31 |
Carol A Cerniauskas | 34 Pickens Drive, Newington, CT 06111 | Registered Nurse | 2000-04-06 ~ 2001-04-30 |
Barbara A Pickens | 1040 Homestead Ln, Villa Ridge, MO 63089-1410 | Registered Nurse | 2012-06-01 ~ 2013-05-31 |
Barbara Diane Pickens | 2500 Big Ivy Rd, Savannah, TN 38372-6308 | Registered Nurse - Temporary | 2017-03-23 ~ 2017-07-20 |
Christine A Pickens | 5 Country Ridge Drive North, Ryebrook, NY 10573 | Registered Nurse | 2019-12-01 ~ 2020-11-30 |
Philip Omar N Libiran | 41 Pickens St, Little Ferry, CT 07643 | Licensed Practical Nurse | 2007-05-24 ~ 2008-05-31 |
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Data Provider | Connecticut Department of Consumer Protection |
Jurisdiction | Connecticut |
Related Datasets | Connecticut Business Registrations, Connecticut Child Care Facilities |
This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).