Provider Demographics
NPI:1063463438
Name:ARVIDSON, KARREN YVONNE (RN, CRNFA)
Entity Type:Individual
Prefix:MRS
First Name:KARREN
Middle Name:YVONNE
Last Name:ARVIDSON
Suffix:
Gender:F
Credentials:RN, CRNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20479 COUNTY 95
Mailing Address - Street 2:
Mailing Address - City:LAPORTE
Mailing Address - State:MN
Mailing Address - Zip Code:56461-4122
Mailing Address - Country:US
Mailing Address - Phone:218-224-2121
Mailing Address - Fax:218-224-4032
Practice Address - Street 1:1300 ANNE ST NW
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-5103
Practice Address - Country:US
Practice Address - Phone:218-333-5773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 068754-6163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNPR00 A09890912012OtherPREFERRED ONE
MNBC002 549T6AROtherBLUE CROSS
MNBC00 549T6AROtherBLUE CROSS
MNHP00 HP4919OtherHEALTH PARTNERS
PR23 A09890912012OtherPREFERRED ONE
MNC001 549T6AROtherBLUE CROSS