Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 05-31489 | KS |
N | 111NI0900X | Internist | 05-31489 | KS |
N | 207R00000X | Internist | 2004007497 | MO |
N | 111NI0900X | Internist | 2004007497 | MO |
N | 207RA0201X | Internist - Allergy & Immunology | 2004007497 | MO |
NPI | 1720059942 |
---|---|
Provider Name | Heather Michelle Kort |
First Address | Overland Park, KS 66209-3721 |
Second Address | Overland Park, KS 66209-3721 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2006 |
Last Update Date | 11/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200374590A | (05) | KS |
207346909 | (05) | MO |
I33094 | (02) |