Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | 0536117 | KS |
Y | 207RH0003X | Hematology & Oncology | 2014005674 | MO |
NPI | 1063672012 |
---|---|
Provider Name | Marci Rachel Allen |
First Address | Lenexa, KS 66219-1374 |
Second Address | Kansas City, MO 64154-1910 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2008 |
Last Update Date | 11/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1063672012 | (05) | MO |
201099480C | (05) | KS |
201099480D | (05) | KS |