Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 2015016102 | MO |
N | 363LG0600X | Nurse Practitioner - Gerontology | 53-76780-092 | KS |
NPI | 1013398957 |
---|---|
Provider Name | Mrs. Karen Elaine Spencer |
First Address | Kansas City, MO 64187-5743 |
Second Address | Leawood, KS 66211-1468 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2015 |
Last Update Date | 07/10/2016 |