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General NPI Number Information
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NPI Number | 1790267664
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Entity Type | Individual
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Provider Name | KARA OMLOR PA-C, AT-C
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Gender | Female
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Dates
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Enumeration Date | 09/06/2018
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Last Update Date | 10/23/2019
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Provider Practice Location Address
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Address Line | 3333 BURNET AVE ML 1013
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City | CINCINNATI
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State | OH
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Zip | 45229
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Country | US
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Telephone | 513-636-4466
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Fax | 513-636-5846
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Provider Business Mailing Address
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Address Line | 3333 BURNET AVE ML 1013
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City | CINCINNATI
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State | OH
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Zip | 45229-3026
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Country | US
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Telephone | 513-636-4466
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Fax | 513-636-5846
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | TC765
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 50.006249RX
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License Number State | OH
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