Provider Demographics
NPI:1033853874
Name:PERDUE, KARA LINN
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:LINN
Last Name:PERDUE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19045 E VALLEY VIEW PKWY STE G
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-9935
Mailing Address - Country:US
Mailing Address - Phone:816-398-7171
Mailing Address - Fax:
Practice Address - Street 1:19045 E VALLEY VIEW PKWY STE G
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-9935
Practice Address - Country:US
Practice Address - Phone:816-398-7171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-27
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO202209226363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health