Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 0116031564 | VA |
Y | 2080P0210X | Pediatric Nephrologist | 2021024495 | MO |
NPI | 1952893877 |
---|---|
Provider Name | Ana Lucia Cortez |
First Address | Overland Park, KS 66210 |
Second Address | Kansas City, MO 64108-4619 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2018 |
Last Update Date | 04/08/2021 |