Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 2013012603 | MO |
Y | 2080P0207X | Pediatric Hematology-Oncologist | 2013016203 | MO |
NPI | 1023281953 |
---|---|
Provider Name | Dr. Katherine Marie Chastain |
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 | 11/04/2008 |
Last Update Date | 25/09/2013 |