Provider Demographics
NPI:1942872866
Name:LUPTON, KARA CHRISTINE (CRNA)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:CHRISTINE
Last Name:LUPTON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:CHRISTINE
Other - Last Name:BROOKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:338 TAPPAN ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43201-3346
Mailing Address - Country:US
Mailing Address - Phone:937-271-6563
Mailing Address - Fax:
Practice Address - Street 1:700 CHILDRENS DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2664
Practice Address - Country:US
Practice Address - Phone:614-722-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-12
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH426414163W00000X
OHAPRN.CNP.0020476367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0475193Medicaid