Healthcare Provider Details

I. General information

NPI: 1457822082
Provider Name (Legal Business Name): JWAN ALALLAF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2018
Last Update Date: 06/15/2025
Certification Date: 06/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15300 COLLEGE BLVD
LENEXA KS
66219-1418
US

IV. Provider business mailing address

600 NE 98TH TER
KANSAS CITY MO
64155-2051
US

V. Phone/Fax

Practice location:
  • Phone: 615-405-1939
  • Fax:
Mailing address:
  • Phone: 785-317-4603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number94-11288
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number2022046389
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: