Provider Demographics
NPI:1902896483
Name:KARNITSCHNIG, LAURA M (CPNP)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:M
Last Name:KARNITSCHNIG
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:M
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:3120 CLEARWATER DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-7131
Mailing Address - Country:US
Mailing Address - Phone:928-778-4581
Mailing Address - Fax:382-776-1872
Practice Address - Street 1:3120 CLEARWATER DRIVE
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305
Practice Address - Country:US
Practice Address - Phone:382-778-4581
Practice Address - Fax:928-776-1872
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200040180RN163WP0200X
OR200350107NP363LP0200X
AZAP2328363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR029081Medicaid