Provider Demographics
NPI:1447631940
Name:LUTOSTANSKI, KAREN (FNP-C, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:LUTOSTANSKI
Suffix:
Gender:F
Credentials:FNP-C, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3218 E BELL RD
Mailing Address - Street 2:UNIT 1182
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2727
Mailing Address - Country:US
Mailing Address - Phone:480-269-5260
Mailing Address - Fax:480-863-3972
Practice Address - Street 1:26 S DESERT AVE
Practice Address - Street 2:
Practice Address - City:LITCHFIELD PARK
Practice Address - State:AZ
Practice Address - Zip Code:85340-4619
Practice Address - Country:US
Practice Address - Phone:480-269-5260
Practice Address - Fax:480-863-3972
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-11
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP8032363LF0000X
AZAP11517363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily