Provider Demographics
NPI:1104867589
Name:OHLSON, KARIN E (NP)
Entity Type:Individual
Prefix:
First Name:KARIN
Middle Name:E
Last Name:OHLSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6554 E CARONDELET DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-2117
Mailing Address - Country:US
Mailing Address - Phone:520-664-5301
Mailing Address - Fax:520-225-0699
Practice Address - Street 1:6554 E CARONDELET DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-2117
Practice Address - Country:US
Practice Address - Phone:520-664-5301
Practice Address - Fax:520-225-0699
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3294363LG0600X
AZAP11791363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ415121Medicaid
AZZ130972Medicare PIN