Provider Demographics
NPI:1205102704
Name:KARVONEN, LORI KEMPF
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:KEMPF
Last Name:KARVONEN
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 1:36049 MAYONI ST
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-8562
Mailing Address - Country:US
Mailing Address - Phone:907-953-0820
Mailing Address - Fax:
Practice Address - Street 1:36049 MAYONI ST
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-8562
Practice Address - Country:US
Practice Address - Phone:907-953-0820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK106991163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant