Provider Demographics
NPI:1447562632
Name:SMITH, KARA ELIZABETH (MS, ATC, LAT)
Entity Type:Individual
Prefix:MRS
First Name:KARA
Middle Name:ELIZABETH
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 QUISENBERRY LN
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-8508
Mailing Address - Country:US
Mailing Address - Phone:518-669-2749
Mailing Address - Fax:
Practice Address - Street 1:1300 ACADEMY DR
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-2654
Practice Address - Country:US
Practice Address - Phone:270-484-2652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-05
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYAT1021246Z00000X
NY001829246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other