Individual
KARA STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9436 ARUNDEL RUN, FORT WAYNE, IN 46835-9115
(260) 492-3730
Mailing address
9436 ARUNDEL RUN, FORT WAYNE, IN 46835-9115
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06006204A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BGI812306494
BLUE CROSS BLUE SHIELD
—
Enumeration date
06/21/2021
Last updated
06/21/2021
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