Healthcare Provider Details

I. General information

NPI: 1245915966
Provider Name (Legal Business Name): CARMEN LORENA CAJINA AGUIRRE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2023
Last Update Date: 08/21/2023
Certification Date: 06/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 RAINBOW BLVD MS 2027
KANSAS CITY KS
66160
US

IV. Provider business mailing address

3901 RAINBOW BLVD MS 2027
KANSAS CITY KS
66160
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-3974
  • Fax:
Mailing address:
  • Phone: 913-588-3974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: