Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VX0201X | Gynecologic Oncologist | 53-79970-071 | KS |
Y | 363L00000X | Nurse Practitioner | 53-79970-071 | KS |
NPI | 1053999185 |
---|---|
Provider Name | Mrs. Anna Garrison |
First Address | Overland Park, KS 66209-2002 |
Second Address | Overland Park, KS 66209-2002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2021 |
Last Update Date | 27/01/2022 |