Provider Demographics
NPI:1164564456
Name:BURKHART, KARA MARIE (ND, LAC)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:MARIE
Last Name:BURKHART
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:192 PARK RD
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06119-2013
Mailing Address - Country:US
Mailing Address - Phone:860-284-4406
Mailing Address - Fax:860-606-9828
Practice Address - Street 1:192 PARK RD
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06119-2013
Practice Address - Country:US
Practice Address - Phone:860-284-4406
Practice Address - Fax:860-606-8928
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00001303175F00000X
CT000484175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath