Healthcare Provider Details

I. General information

NPI: 1194351635
Provider Name (Legal Business Name): KARA LYNN MALAGHAN CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARA LYNN BRADT CNP-PC

II. Dates (important events)

Enumeration Date: 03/17/2020
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10359 CROSS CREEK BLVD
TAMPA FL
33647-2772
US

IV. Provider business mailing address

19522 BROAD SHORE WALK
LOXAHATCHEE FL
33470-2169
US

V. Phone/Fax

Practice location:
  • Phone: 813-994-0044
  • Fax:
Mailing address:
  • Phone: 813-505-2414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN11006042
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: