Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0210X | Pediatric Nephrologist | 04-38214 | KS |
Y | 2080P0210X | Pediatric Nephrologist | 2015012591 | MO |
NPI | 1932343910 |
---|---|
Provider Name | Darcy Kate Weidemann |
First Address | Kansas City, MO 64108-4619 |
Second Address | Kansas City, MO 64108-4619 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2009 |
Last Update Date | 21/07/2015 |