Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | LL163338 | OR |
N | 2080P0210X | Pediatric Nephrologist | 0435995 | KS |
Y | 2080P0210X | Pediatric Nephrologist | 2012028976 | MO |
NPI | 1558568964 |
---|---|
Provider Name | Laurel Kay Willig |
First Address | Kansas City, MO 64108-4619 |
Second Address | Kansas City, MO 64108-4619 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2007 |
Last Update Date | 30/01/2013 |