Provider Demographics
NPI:1245762442
Name:ANDERSON, KARA LEE (DNP, APRN, CPNP-PC)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:LEE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:DNP, APRN, CPNP-PC
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:LEE
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 776879
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6879
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:234 E GRAY ST STE 334
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1902
Practice Address - Country:US
Practice Address - Phone:502-882-9237
Practice Address - Fax:502-893-3900
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3010648363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics