Healthcare Provider Details

I. General information

NPI: 1538608781
Provider Name (Legal Business Name): KARA EVERETT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2017
Last Update Date: 02/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16356 COUNTY ROAD 41
ADDISON AL
35540-2416
US

IV. Provider business mailing address

16356 COUNTY ROAD 41
ADDISON AL
35540-2416
US

V. Phone/Fax

Practice location:
  • Phone: 256-747-1186
  • Fax:
Mailing address:
  • Phone: 256-747-1186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number1-131564
License Number StateAL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: