Provider Demographics
NPI:1295819381
Name:FLATT, KARA DANIELLE (APN)
Entity type:Individual
Prefix:MRS
First Name:KARA
Middle Name:DANIELLE
Last Name:FLATT
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MS
Other - First Name:KARA
Other - Middle Name:DANIELLE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:109 CALIFORNIA ST
Mailing Address - Street 2:PO BOX 577
Mailing Address - City:CARTERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62918-0577
Mailing Address - Country:US
Mailing Address - Phone:618-519-9200
Mailing Address - Fax:618-985-4635
Practice Address - Street 1:1700 WILDCAT DR STE A
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959-1513
Practice Address - Country:US
Practice Address - Phone:618-519-9200
Practice Address - Fax:618-998-0880
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209017994363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner