Provider Demographics
NPI:1538716709
Name:SMITH, KARA R (RN)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:R
Last Name:SMITH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ROHERSTOWN RD
Mailing Address - Street 2:BLD 6
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 ROHERSTOWN RD
Practice Address - Street 2:BLD 6
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-1760
Practice Address - Country:US
Practice Address - Phone:717-371-6616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-22
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA623751163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse