Individual
KAREN LYNN MODRZEJEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
13395 N MARANA MAIN ST BLDG B, MARANA, AZ 85653-7008
(520) 682-1091
(520) 682-4132
Mailing address
PO BOX 188, MARANA, AZ 85653-0188
(520) 682-4111
(520) 818-3630
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
114985
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP10946
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
354315
—
AZ
Enumeration date
11/19/2010
Last updated
07/22/2021
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