Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | 2004012535 | MO |
Y | 363LA2200X | Nurse Practitioner - Adult Health | 45768 | KS |
NPI | 1013002542 |
---|---|
Provider Name | Carrie L Englert |
First Address | Overland Park, KS 66210-2002 |
Second Address | Overland Park, KS 66210-4045 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 23/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1013002542 | (05) | MO |
200347050C | (05) | KS |
Q51612 | (02) |