Kabara, Pollyanna

Kabara, Pollyanna is an individual health care provider with primary practice located at Lakeside Pediatrics 8600 75Th Street, Kenosha WI 53142. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Kabara, Pollyanna can be contacted via phone (262) 652-9430.

Contact Information

Primary practice address
Lakeside Pediatrics 8600 75Th Street Kenosha WI 53142
Phone: (262) 652-9430
Fax: (262) 652-9433
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1389 Wisconsin

Profile Details

NPI number 1134173479
LBN Legal business name Kabara, Pollyanna
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 20th, 2006
Last updated Jan 11th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134173479 NPPES
Wisconsin MEDICAID 1134173479
Wisconsin Other 008006261X

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