Provider Demographics
NPI:1609008655
Name:LAIRD, KAREN M (FNP-C)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:LAIRD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:910-721-4400
Mailing Address - Fax:910-721-4409
Practice Address - Street 1:200 NOLA RUTH BLVD
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-6074
Practice Address - Country:US
Practice Address - Phone:877-800-5722
Practice Address - Fax:254-698-1673
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-10
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX612814363LF0000X
NCF0709104363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP118043OtherLICENSE
TX3100083-01Medicaid
TXAP118043OtherLICENSE