Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 2017029226 | MO |
N | 207VX0000X | Obstetrician | 4301105762 | MI |
NPI | 1164786166 |
---|---|
Provider Name | Dr. Kia S Lannaman |
First Address | Saint Louis, MO 63117-1811 |
Second Address | Saint Louis, MO 63117-1858 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2012 |
Last Update Date | 06/11/2020 |