Provider Demographics
NPI:1851791115
Name:ADAMS, KARLA KAY (NP-C)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:KAY
Last Name:ADAMS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MRS
Other - First Name:KARLA
Other - Middle Name:KAY
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP-C
Mailing Address - Street 1:1701 ARLINGTON DR
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83204-5009
Mailing Address - Country:US
Mailing Address - Phone:208-850-2855
Mailing Address - Fax:
Practice Address - Street 1:1701 ARLINGTON DR
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83204-5009
Practice Address - Country:US
Practice Address - Phone:208-850-2855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-23
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDN-28469363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily