Provider Demographics
NPI:1114257854
Name:PETERSON, KARA M (CNM)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:M
Last Name:PETERSON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3015 GRAYSON AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15227-2501
Mailing Address - Country:US
Mailing Address - Phone:412-867-8625
Mailing Address - Fax:
Practice Address - Street 1:249 S 9TH ST FL 1
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203-1265
Practice Address - Country:US
Practice Address - Phone:412-697-3260
Practice Address - Fax:412-697-3263
Is Sole Proprietor?:No
Enumeration Date:2009-12-31
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMW010206367A00000X
PASP028548363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife