Provider Demographics
NPI:1801255682
Name:SPECHT, KARA NICOLE (PA-C)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:NICOLE
Last Name:SPECHT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:
Other - Last Name:BOZICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:320 E NORTH AVE
Mailing Address - Street 2:SUITE 363
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4756
Mailing Address - Country:US
Mailing Address - Phone:412-359-6137
Mailing Address - Fax:412-359-4334
Practice Address - Street 1:320 E NORTH AVE
Practice Address - Street 2:SUITE 363
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4756
Practice Address - Country:US
Practice Address - Phone:412-359-6137
Practice Address - Fax:412-359-4334
Is Sole Proprietor?:No
Enumeration Date:2016-02-22
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA058079363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103265648Medicaid
13044027OtherCAQH