Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 2010011906 | MO |
N | 207RC0000X | Internist - Cardiovascular Disease | 2010011906 | MO |
NPI | 1720258122 |
---|---|
Provider Name | Bethany Anne Austin |
First Address | Kansas City, MO 64111-5939 |
Second Address | Kansas City, MO 64111 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2008 |
Last Update Date | 21/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200663430B | (05) | KS |
200663430C | (05) | KS |