Provider Demographics
NPI:1093341687
Name:DOBYNS, KARA (PMHNP)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:DOBYNS
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 W BROADWAY
Mailing Address - Street 2:
Mailing Address - City:WITT
Mailing Address - State:IL
Mailing Address - Zip Code:62094-1053
Mailing Address - Country:US
Mailing Address - Phone:217-565-0054
Mailing Address - Fax:
Practice Address - Street 1:911 STACEY BURK DR
Practice Address - Street 2:
Practice Address - City:FLORA
Practice Address - State:IL
Practice Address - Zip Code:62839-3241
Practice Address - Country:US
Practice Address - Phone:618-662-2131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-16
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209021038363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health