Healthcare Provider Details

I. General information

NPI: 1184264368
Provider Name (Legal Business Name): HANNAH KARSTEN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2020
Last Update Date: 10/28/2022
Certification Date: 10/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3917 WEST RD STE 200
LOS ALAMOS NM
87544-5301
US

IV. Provider business mailing address

1620 N MAIN ST
SPANISH FORK UT
84660-1008
US

V. Phone/Fax

Practice location:
  • Phone: 505-661-4147
  • Fax:
Mailing address:
  • Phone: 801-822-2234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA2021-0049
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: