Provider Demographics
NPI:1184615379
Name:HEYING, KARA ELIZABETH (OD)
Entity type:Individual
Prefix:DR
First Name:KARA
Middle Name:ELIZABETH
Last Name:HEYING
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:KARA
Other - Middle Name:ELIZABETH
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:4207 GLASS ROAD NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402
Mailing Address - Country:US
Mailing Address - Phone:319-366-4455
Mailing Address - Fax:319-362-8461
Practice Address - Street 1:4207 GLASS ROAD NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402
Practice Address - Country:US
Practice Address - Phone:319-366-4455
Practice Address - Fax:319-362-8461
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA2110152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1175919Medicaid
IA1175919Medicaid
IA4011190001Medicare NSC
IAI0597Medicare ID - Type Unspecified