Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0127X | Trauma Surgeon | 2021040572 | MO |
NPI | 1366107526 |
---|---|
Provider Name | Mrs. Katelyn Nicole Seibel |
First Address | Kansas City, KS 66160 |
Second Address | Kansas City, KS 66160 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2021 |
Last Update Date | 03/11/2021 |