Provider Demographics
NPI:1770840175
Name:ROBERTS, KARA GRACE (CRNP)
Entity Type:Individual
Prefix:MISS
First Name:KARA
Middle Name:GRACE
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:CRNP
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Mailing Address - Street 1:2846 THORNHILL RD APT 51A
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35213-4040
Mailing Address - Country:US
Mailing Address - Phone:205-638-5840
Mailing Address - Fax:205-975-1941
Practice Address - Street 1:1600 7TH AVE S
Practice Address - Street 2:LOWDER 512
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1711
Practice Address - Country:US
Practice Address - Phone:205-638-5840
Practice Address - Fax:205-975-1941
Is Sole Proprietor?:No
Enumeration Date:2012-04-23
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL1-109658363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics