Individual provider Active NPI

Laurie Lynn Williamson, ARNP

  • Neonatal Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1790879880
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
AP30003997 Issued in WA
Practice address
1661 E Camelback Rd Ste 200
Phoenix, AZ 85016-3913
Phone
(602) 858-6754
Fax
(602) 559-5641
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 0024196600 VA
Neonatal Nurse Practitioner 363LN0000X AP30003997 WA Primary
Neonatal Nurse Practitioner 363LN0000X AP8310 AZ

Addresses

Primary practice location

1661 E Camelback Rd Ste 200
Phoenix, AZ 85016-3913

Mailing address

1661 E Camelback Rd Ste 200
Phoenix, AZ 85016-3913
Phone (602) 858-6754

Other identifiers 1

IdentifierTypeStateIssuer
1790879880MedicaidWA

Other names 1

  • Laurie Kinney Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251103002086 AZ Practitioner - Nurse Practitioner 9830282706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1625 N Campbell Ave
Tucson, AZ 85719-4330

525 W Brown Rd
Mesa, AZ 85201-3202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP8310AZMDNeonatal Nurse Practitioner
0024196600VAMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group CurrentSince Oct 27, 2025 Accepting new patients
Banner-University Medical Group CurrentSince Oct 27, 2025 Accepting new patients
Arizona OB GYN Affiliates PC Past Accepting new patients

Locations

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

1625 N Campbell Ave
Tucson, AZ 85719

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1790879880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1661 E CAMELBACK RD STE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850163913",
            "telephone_number": "602-858-6754",
            "fax_number": "602-559-5641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1661 E CAMELBACK RD STE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850163913",
            "telephone_number": "602-858-6754",
            "fax_number": "602-559-5641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "LAURIE",
        "middle_name": "LYNN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "VA",
            "license": "0024196600",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "WA",
            "license": "AP30003997",
            "primary": true
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "AZ",
            "license": "AP8310",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790879880",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURIE",
            "last_name": "KINNEY",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.