Provider Demographics
NPI:1033553292
Name:LEVY, KARA LALIBERTE (NP)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:LALIBERTE
Last Name:LEVY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:LYNNE
Other - Last Name:LALIBERTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1026
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-1026
Mailing Address - Country:US
Mailing Address - Phone:317-777-6435
Mailing Address - Fax:317-777-6644
Practice Address - Street 1:705 RILEY HOSPITAL DR
Practice Address - Street 2:RI 1601
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5109
Practice Address - Country:US
Practice Address - Phone:317-944-4846
Practice Address - Fax:317-948-0126
Is Sole Proprietor?:No
Enumeration Date:2013-04-18
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28169799A363LF0000X
IN71004419A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201178690Medicaid
IN145590148Medicare PIN