Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 105374 | MO |
NPI | 1013282664 |
---|---|
Provider Name | Kimberly Kay Pluenneke |
First Address | Overland Park, KS 66210-2036 |
Second Address | Kansas City, MO 64154-1910 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2012 |
Last Update Date | 15/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F76363 | (02) | MO |