Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 4604 | KS |
N | 111NN1001X | Nutrition | 4604 | KS |
NPI | 1215092176 |
---|---|
Provider Name | Dr. Georgia J. Nab |
First Address | Overland Park, KS 66202-2201 |
Second Address | Shawnee, KS 66203-4550 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2006 |
Last Update Date | 17/03/2019 |