Provider Demographics
NPI:1114051893
Name:STONE, KARA B (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KARA
Middle Name:B
Last Name:STONE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:KARA
Other - Middle Name:LYNN
Other - Last Name:BOLCAVAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:8125 BLUE NEEDLE LN
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27539-7941
Mailing Address - Country:US
Mailing Address - Phone:919-610-9232
Mailing Address - Fax:
Practice Address - Street 1:2840 PLAZA PL STE 110
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-6342
Practice Address - Country:US
Practice Address - Phone:866-691-4427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-00740363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8103010Medicaid
NC2768984Medicare PIN