Provider Demographics
NPI:1376322800
Name:PAINE, LAARNIE SALAZAR
Entity Type:Individual
Prefix:MRS
First Name:LAARNIE
Middle Name:SALAZAR
Last Name:PAINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:476 BUCKSKIN TRL
Mailing Address - Street 2:
Mailing Address - City:KANSAS
Mailing Address - State:OK
Mailing Address - Zip Code:74347-9325
Mailing Address - Country:US
Mailing Address - Phone:479-549-8929
Mailing Address - Fax:
Practice Address - Street 1:476 BUCKSKIN TRL
Practice Address - Street 2:
Practice Address - City:KANSAS
Practice Address - State:OK
Practice Address - Zip Code:74347-9325
Practice Address - Country:US
Practice Address - Phone:479-549-8929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider