Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0200X | Nurse Practitioner - Pediatrics | 2012040795 | MO |
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 5375870-081 | KS |
NPI | 1013253483 |
---|---|
Provider Name | Erin Fecske |
First Address | Overland Park, KS 66211-2504 |
Second Address | Overland Park, KS 66211-2504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2012 |
Last Update Date | 12/12/2012 |