Healthcare Provider Details

I. General information

NPI: 1902896483
Provider Name (Legal Business Name): LAURA M KARNITSCHNIG CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA M WALKER RN

II. Dates (important events)

Enumeration Date: 10/25/2005
Last Update Date: 07/15/2024
Certification Date: 07/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4824 E BASELINE RD STE 125
MESA AZ
85206-4679
US

IV. Provider business mailing address

19002 N 41ST PL
PHOENIX AZ
85050-3701
US

V. Phone/Fax

Practice location:
  • Phone: 480-839-4848
  • Fax:
Mailing address:
  • Phone: 928-379-0990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number200040180RN
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number200350107NP
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAP2328
License Number StateAZ
# 4
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP2328
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: