Provider Demographics
NPI:1184291759
Name:SPEARS, KARA JOY (CSFA)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:JOY
Last Name:SPEARS
Suffix:
Gender:F
Credentials:CSFA
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:JOY
Other - Last Name:SIBLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSFA
Mailing Address - Street 1:12686 44TH AVE
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-6607
Mailing Address - Country:US
Mailing Address - Phone:715-520-2770
Mailing Address - Fax:
Practice Address - Street 1:19333 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-4132
Practice Address - Country:US
Practice Address - Phone:715-520-2770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171069246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
171069OtherCSFA/ CST CERTIFICATION NUMBER