Provider Demographics
NPI:1700287976
Name:POLLACK, KARA ROSE (AGNP-C)
Entity Type:Individual
Prefix:MRS
First Name:KARA
Middle Name:ROSE
Last Name:POLLACK
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1975 GRANT ST
Mailing Address - Street 2:414
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-1127
Mailing Address - Country:US
Mailing Address - Phone:512-968-7539
Mailing Address - Fax:303-433-7452
Practice Address - Street 1:5075 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80216-2015
Practice Address - Country:US
Practice Address - Phone:303-458-5302
Practice Address - Fax:303-433-7452
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-08
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0991410-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner