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Individual

MRS. KARA ELLIOTT BOUTWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
3 MOBILE INFIRMARY CIR, SUITE 302B, MOBILE, AL 36607-3520
(251) 607-5400
Mailing address
3 MOBILE INFIRMARY CIR, SUITE 302B, MOBILE, AL 36607-3520
(251) 607-5400

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1073518
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
102I502361
MEDICARE PTAN
AL
05
213895
AL
01
P02566962
RAILROAD MEDICARE
AL
Enumeration date
07/29/2014
Last updated
10/27/2021
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