Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | F0215212 | MO |
NPI | 1003207820 |
---|---|
Provider Name | Mary Kathryn Allinder |
First Address | Gladstone, MO 64118-4054 |
Second Address | Gladstone, MO 64118-4054 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2015 |
Last Update Date | 17/02/2015 |