Provider Demographics
NPI:1043252562
Name:MARCINEK, KARA REBECCA (ARNP)
Entity type:Individual
Prefix:MRS
First Name:KARA
Middle Name:REBECCA
Last Name:MARCINEK
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20270 E SMOKY HILL RD
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80015-3138
Mailing Address - Country:US
Mailing Address - Phone:303-693-2000
Mailing Address - Fax:303-693-2043
Practice Address - Street 1:20270 E SMOKY HILL RD
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80015-3138
Practice Address - Country:US
Practice Address - Phone:303-693-2000
Practice Address - Fax:303-693-2043
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0010288-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP88792Medicare UPIN