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NPI Code Detail

MEDICARE: MRS. LAURA ANNE KARADIMAS FNP-C

MEDICARE:  MRS. LAURA ANNE KARADIMAS  FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner4704190382MI

General Provider Information

NPI Number : 1790336907
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LAURA ANNE KARADIMAS FNP-C
Provider Business Mailing Address
First Line : 1163 S CARNEY DR
Second Line :
City : SAINT CLAIR
State : MI
Zip : 48079-5569
Country : US
Telephone Number : 810-561-8450
Fax Number : 810-329-0156
Provider Business Practice Location Address
First Line : 1163 S CARNEY DR
Second Line :
City : SAINT CLAIR
State : MI
Zip : 48079-5569
Country : US
Telephone Number : 810-561-8450
Fax Number : 810-329-0156
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2019
Last Update Date : 03/29/2021

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Directions to “ MRS. LAURA ANNE KARADIMAS FNP-C” Practice Location

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