Provider Demographics
NPI:1760078125
Name:LARUE, KARA B (PNP)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:B
Last Name:LARUE
Suffix:
Gender:F
Credentials:PNP
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Mailing Address - Street 1:1275 DICK LONAS RD UNIT 101
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-1383
Mailing Address - Country:US
Mailing Address - Phone:865-584-4747
Mailing Address - Fax:833-908-0998
Practice Address - Street 1:9142 S NORTHSHORE DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-6325
Practice Address - Country:US
Practice Address - Phone:865-670-1560
Practice Address - Fax:833-908-2111
Is Sole Proprietor?:No
Enumeration Date:2020-12-18
Last Update Date:2021-02-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN197769163W00000X
TN28711363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse