Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RN0300X | Nephrologist | 2011013287 | MO |
N | 208000000X | Pediatrician | 2011013287 | MO |
Y | 2080P0210X | Pediatric Nephrologist | 2011013287 | MO |
NPI | 1790972586 |
---|---|
Provider Name | Dr. Laura Ellen Hesemann |
First Address | Kansas City, MO 64184-3966 |
Second Address | Columbia, MO 65201-6626 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2007 |
Last Update Date | 09/05/2019 |