Provider Demographics
NPI:1801548649
Name:BLADEN, KARA MICHELLE
Entity type:Individual
Prefix:MISS
First Name:KARA
Middle Name:MICHELLE
Last Name:BLADEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:797 W 29TH AVE UNIT 2424
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-1752
Mailing Address - Country:US
Mailing Address - Phone:812-701-0387
Mailing Address - Fax:
Practice Address - Street 1:797 W 29TH AVE UNIT 2424
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-1752
Practice Address - Country:US
Practice Address - Phone:812-701-0387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-24
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program