Provider Demographics
NPI:1194366401
Name:ADAMS, KARRA NANCE (DNP)
Entity type:Individual
Prefix:
First Name:KARRA
Middle Name:NANCE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 959203
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63195-9203
Mailing Address - Country:US
Mailing Address - Phone:618-463-8500
Mailing Address - Fax:618-433-6792
Practice Address - Street 1:1 PROFESSIONAL DR STE 220
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-5068
Practice Address - Country:US
Practice Address - Phone:618-463-8500
Practice Address - Fax:618-433-6792
Is Sole Proprietor?:No
Enumeration Date:2019-10-08
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209020048363LF0000X
MO2019034491363L00000X
IL734660363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily