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Individual

KARIN VANNIEUWENHUIZEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.-C

Contact information

Practice address
1003 WILLOW CREEK RD, PRESCOTT, AZ 86301-1641
(928) 445-2700
Mailing address
2291 ALTA VISTA PL, PRESCOTT, AZ 86301-5350

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
2130
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
456104
AZ
Enumeration date
05/28/2006
Last updated
07/08/2007
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