Provider Demographics
NPI:1972596930
Name:CARLIN, KAREN H (ANP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:H
Last Name:CARLIN
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:H
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP
Mailing Address - Street 1:8520 E SHEA BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6677
Mailing Address - Country:US
Mailing Address - Phone:480-588-6924
Mailing Address - Fax:480-634-5819
Practice Address - Street 1:8520 E SHEA BLVD
Practice Address - Street 2:STE 100
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6677
Practice Address - Country:US
Practice Address - Phone:480-588-6924
Practice Address - Fax:480-634-5819
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP1807363LA2200X
AZRN124198363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZP77035Medicare UPIN
AZZ139258Medicare Oscar/Certification