Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 61582 | KS |
NPI | 1073045902 |
---|---|
Provider Name | Amy Linn Vermeer |
First Address | Overland Park, KS 66211-1314 |
Second Address | Overland Park, KS 66211-1314 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2017 |
Last Update Date | 29/10/2020 |