MEDICARE: KARE HENRIKSON LYCHE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	A061158	CA
2	207Q00000X	Family Medicine Physician	2006020977	MO
3	207Q00000X	Family Medicine Physician	32015	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902960990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARE HENRIKSON LYCHE MD

Provider Business Mailing Address
First Line	:	407 S CLAIRBORNE RD STE 104
Second Line	:
City	:	OLATHE
State	:	KS
Zip	:	66062-1744
Country	:	US
Telephone Number	:	913-468-2266
Fax Number	:

Provider Business Practice Location Address
First Line	:	407 S CLAIRBORNE RD STE 104
Second Line	:
City	:	OLATHE
State	:	KS
Zip	:	66062-1744
Country	:	US
Telephone Number	:	913-468-2266
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/21/2006
Last Update Date	:	08/20/2019

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Directions to “ KARE HENRIKSON LYCHE MD” Practice Location

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