Provider Demographics
NPI:1194525329
Name:JOLL, KARA MARIE (PMHNP)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:MARIE
Last Name:JOLL
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9045 NW EGRET ST
Mailing Address - Street 2:
Mailing Address - City:SEAL ROCK
Mailing Address - State:OR
Mailing Address - Zip Code:97376-9645
Mailing Address - Country:US
Mailing Address - Phone:541-961-8753
Mailing Address - Fax:
Practice Address - Street 1:9045 NW EGRET ST
Practice Address - Street 2:
Practice Address - City:SEAL ROCK
Practice Address - State:OR
Practice Address - Zip Code:97376-9645
Practice Address - Country:US
Practice Address - Phone:541-961-8753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200540138RN363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health