Individual
KARA TRAVIS MUDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3810 SPRINGHURST BLVD STE 200, LOUISVILLE, KY 40241
(502) 583-1749
(502) 329-8184
Mailing address
PO BOX 950132, LOUISVILLE, KY 40295-0132
(888) 980-8992
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1064
KY
363AM0700X
Medical Physician Assistant
PA1064
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000608608
ANTHEM- NORTON ORTHO TRAUMA CARE
KY
01
—
000023035V
HUMANA- NORTON ORTHO TRAUMA CARE
KY
01
—
00533117
MEDICARE- NORTON ORTHO TRAUMA CARE
KY
01
—
3704756000
PASSPORT ADVANTAGE- NORTON ORTHO TRAUMA CARE
KY
01
—
50023180
PASSPORT- NORTON ORTHO TRAUMA CARE
KY
01
—
611276316-106
TRICARE- NORTON ORTHO TRAUMA CARE
KY
05
—
7100040740
—
KY
01
—
P00764030
RAILROAD MEDICARE- NORTON ORTHO TRAUMA CARE
KY
Enumeration date
09/12/2007
Last updated
12/06/2020
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