Healthcare Provider Details

I. General information

NPI: 1770699217
Provider Name (Legal Business Name): CAROLE A PRATHER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 07/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF KANSAS MEDICAL CENTER CCHD 3901 RAINBOW BLVD., MAIL STOP 4003
KANSAS CITY KS
66160-0001
US

IV. Provider business mailing address

PO BOX 411851
KANSAS CITY MO
64141-1851
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-5900
  • Fax: 913-588-5916
Mailing address:
  • Phone: 913-588-5821
  • Fax: 913-588-5916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number45230
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: