Provider Demographics
NPI:1164738951
Name:MESCHKO, KARA D (APRN)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:D
Last Name:MESCHKO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:D
Other - Last Name:HAYNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:35 JOSHUA LANE
Mailing Address - Street 2:
Mailing Address - City:HAWESVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42348
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2211 MAYFAIR DR
Practice Address - Street 2:SUITE 101
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-4568
Practice Address - Country:US
Practice Address - Phone:270-688-1352
Practice Address - Fax:270-688-4313
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-31
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3006600363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100133940Medicaid
IN201044500Medicaid
KY7100133940Medicaid