Healthcare Provider Details

I. General information

NPI: 1164126173
Provider Name (Legal Business Name): PRACHI MAJAMUNDAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8550 MARSHALL DR STE 200
LENEXA KS
66214-9836
US

IV. Provider business mailing address

8550 MARSHALL DR STE 200
LENEXA KS
66214-9836
US

V. Phone/Fax

Practice location:
  • Phone: 913-495-2000
  • Fax: 913-495-3715
Mailing address:
  • Phone: 913-495-2000
  • Fax: 913-495-3715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number15-03270
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: