Provider Demographics
NPI:1619401940
Name:STRATTON, KARA MIA VILLANUEVA (MD)
Entity Type:Individual
Prefix:
First Name:KARA MIA
Middle Name:VILLANUEVA
Last Name:STRATTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KARA MIA
Other - Middle Name:VILLAMIN
Other - Last Name:VILLAMIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8201 HEALTHCARE LOOP STE 302
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-7072
Practice Address - Country:US
Practice Address - Phone:704-316-2319
Practice Address - Fax:704-316-2321
Is Sole Proprietor?:No
Enumeration Date:2017-04-13
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NC2021-02251207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program