Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | 2005008770 | MO |
NPI | 1326074006 |
---|---|
Provider Name | Sean Allen Nix |
First Address | Kansas City, MO 64131 |
Second Address | Kansas City, MO 64111-5942 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2006 |
Last Update Date | 21/11/2017 |