Provider Demographics
NPI:1922704907
Name:POLO, KARA (RN)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:POLO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1677 NW VIEWMONT CT
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-9458
Mailing Address - Country:US
Mailing Address - Phone:608-312-3227
Mailing Address - Fax:
Practice Address - Street 1:1677 NW VIEWMONT CT
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-9458
Practice Address - Country:US
Practice Address - Phone:608-312-3227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60688993163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse