Provider Demographics
NPI:1649878794
Name:LAW, KAREN LYNN
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:LYNN
Last Name:LAW
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 1:1820 E CAPITOL AVE APT 226
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-2182
Mailing Address - Country:US
Mailing Address - Phone:701-550-0507
Mailing Address - Fax:
Practice Address - Street 1:1820 E CAPITOL AVE APT 226
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-2182
Practice Address - Country:US
Practice Address - Phone:701-550-0507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant