Individual
KARA SOPP HARRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
625 S NEW BALLAS RD, SUITE #7040, SAINT LOUIS, MO 63141-8253
(314) 251-6970
(314) 251-1053
Mailing address
576 LACROIX WAY, COLUMBIA, IL 62236-2858
(314) 210-7341
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
001771
IA
363A00000X
Physician Assistant
Primary
2007002748
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00666818
RAILROAD MEDICARE
MO
Enumeration date
10/25/2006
Last updated
09/08/2020
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