MEDICARE: KATHLEEN ANN MILLER

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1972767820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN ANN MILLER

Provider Business Mailing Address
First Line	:	1949 S 49TH ST
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66106-2401
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1949 S 49TH ST
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66106-2401
Country	:	US
Telephone Number	:	913-596-1942
Fax Number	:

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

Provider Enumeration Date	:	07/10/2008
Last Update Date	:	07/10/2008

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