Healthcare Provider Details

I. General information

NPI: 1003477449
Provider Name (Legal Business Name): KARA AUSTIN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KARA POWELL AUSTIN NP

II. Dates (important events)

Enumeration Date: 06/26/2019
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 TALLAHATCHIE ST
GREENWOOD MS
38930-2005
US

IV. Provider business mailing address

609 TALLAHATCHIE ST
GREENWOOD MS
38930-2005
US

V. Phone/Fax

Practice location:
  • Phone: 662-453-2626
  • Fax:
Mailing address:
  • Phone: 662-453-2626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number903411
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: