Basic Information
| Provider Information | |||||||||
| NPI: | 1477795052 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AUBREY | ||||||||
| FirstName: | KARLA | ||||||||
| MiddleName: | DAMILLE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | RRT-NPS | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 36 | ||||||||
| Address2: | 124 E 224 HIWAY | ||||||||
| City: | WELLINGTON | ||||||||
| State: | MO | ||||||||
| PostalCode: | 640970036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8169342592 | ||||||||
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| Practice Location | |||||||||
| Address1: | 601 E 14TH STREET | ||||||||
| Address2: | |||||||||
| City: | SEDALIA | ||||||||
| State: | MO | ||||||||
| PostalCode: | 65301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6608268833 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2009 | ||||||||
| LastUpdateDate: | 03/30/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2279P3900X | 101849 | MO | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Neonatal/Pediatrics |
No ID Information.