Provider Demographics
NPI:1558641415
Name:KELTON, KARA ALYSSA (PA-C)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:ALYSSA
Last Name:KELTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:A
Other - Last Name:MEEKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:301 RIVERVIEW AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-1065
Mailing Address - Country:US
Mailing Address - Phone:757-252-1700
Mailing Address - Fax:757-413-7775
Practice Address - Street 1:301 RIVERVIEW AVE STE 400
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-1065
Practice Address - Country:US
Practice Address - Phone:757-252-1700
Practice Address - Fax:757-413-7775
Is Sole Proprietor?:No
Enumeration Date:2011-08-24
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
VA0110003689363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant