Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 53-76700-121 | KS |
N | 363LG0600X | Nurse Practitioner - Gerontology | 76700 | KS |
NPI | 1063802585 |
---|---|
Provider Name | Kimberly Losik |
First Address | Kansas City, KS 66112-2067 |
Second Address | Kansas City, KS 66112-2067 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2015 |
Last Update Date | 03/12/2021 |