Provider Demographics
NPI:1063883239
Name:ESTRADA, KARLA PATRICIA ENCOMIENDA (FNP-BC, NP-C)
Entity type:Individual
Prefix:
First Name:KARLA PATRICIA
Middle Name:ENCOMIENDA
Last Name:ESTRADA
Suffix:
Gender:F
Credentials:FNP-BC, NP-C
Other - Prefix:
Other - First Name:KARLA PATRICIA
Other - Middle Name:VILLAR
Other - Last Name:ENCOMIENDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1675 S ARLINGTON HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-3769
Mailing Address - Country:US
Mailing Address - Phone:847-258-4978
Mailing Address - Fax:877-701-6974
Practice Address - Street 1:1675 S ARLINGTON HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-3769
Practice Address - Country:US
Practice Address - Phone:847-258-4978
Practice Address - Fax:877-701-6974
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-14
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209013428363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily