Provider Demographics
NPI:1710651658
Name:BATTEN, KARA MICHELE
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:MICHELE
Last Name:BATTEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4221 CORPORAL KENNEDY ST APT 2F
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-2726
Mailing Address - Country:US
Mailing Address - Phone:631-487-8907
Mailing Address - Fax:
Practice Address - Street 1:4221 CORPORAL KENNEDY ST APT 2F
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-2726
Practice Address - Country:US
Practice Address - Phone:631-487-8907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0000000000363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics