Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 2021022219 | MO |
Y | 213EG0000X | General Practice | 2021022219 | MO |
NPI | 1003489584 |
---|---|
Provider Name | Alaina Jo Calabrese |
First Address | Kansas City, MO 64119-4726 |
Second Address | Kansas City, MO 64119-2811 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2021 |
Last Update Date | 09/11/2021 |