MEDICARE: KARA PROBST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	0010-11394	NC

General Provider Information

NPI Number	:	1457923849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARA PROBST

Provider Business Mailing Address
First Line	:	203 MCADOO AVE APT 3D
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27406-1763
Country	:	US
Telephone Number	:	770-639-2237
Fax Number	:

Provider Business Practice Location Address
First Line	:	603A DOLLEY MADISON RD UNIT 100
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27410-4205
Country	:	US
Telephone Number	:	336-632-3505
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2021
Last Update Date	:	04/12/2023

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Directions to “ KARA PROBST ” Practice Location

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