Provider Demographics
NPI:1346776259
Name:ILLINGWORTH, KARA ELIZABETH (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:KARA
Middle Name:ELIZABETH
Last Name:ILLINGWORTH
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 LINDEN DR
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-7020
Mailing Address - Country:US
Mailing Address - Phone:267-981-0527
Mailing Address - Fax:
Practice Address - Street 1:912 LINDEN DR
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-7020
Practice Address - Country:US
Practice Address - Phone:267-981-0527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP132924363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care