Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | 2003016247 | MO |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 2015001944 | MO |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 77058 | KS |
NPI | 1003209404 |
---|---|
Provider Name | Kristi Kreutzer |
First Address | Overland Park, KS 66204 |
Second Address | Overland Park, KS 66204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2015 |
Last Update Date | 28/03/2016 |