Provider Demographics
NPI:1295125946
Name:KOELBEL, KARA (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KARA
Middle Name:
Last Name:KOELBEL
Suffix:
Gender:
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5916 E MCKELLIPS RD
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85215-2755
Mailing Address - Country:US
Mailing Address - Phone:480-930-4477
Mailing Address - Fax:415-252-7176
Practice Address - Street 1:5916 E MCKELLIPS RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85215-2755
Practice Address - Country:US
Practice Address - Phone:480-930-4477
Practice Address - Fax:415-252-7176
Is Sole Proprietor?:No
Enumeration Date:2015-02-03
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP7589363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ013874Medicaid
Z175819OtherMEDICARE PTAN