Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 145295 | MO |
NPI | 1013963438 |
---|---|
Provider Name | Kristina M Calkins |
First Address | Kansas City, MO 64131 |
Second Address | Kansas City, MO 64111-5939 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 06/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200334560A | (05) | KS |
200334560C | (05) | KS |
200334560D | (05) | KS |
427419007 | (05) | MO |
P00836126 | RAILROAD MEDICARE (01) | MO |
P00842716 | RAILROAD MEDICARE (01) | KS |
W51659 | (02) |