Healthcare Provider Details

I. General information

NPI: 1447487780
Provider Name (Legal Business Name): VERONICA M GAVULA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2009
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7450 KESSLER ST STE 202
MERRIAM KS
66204-2553
US

IV. Provider business mailing address

7450 KESSLER ST STE 202
MERRIAM KS
66204-2553
US

V. Phone/Fax

Practice location:
  • Phone: 913-632-9480
  • Fax: 913-632-9499
Mailing address:
  • Phone: 913-632-9480
  • Fax: 913-632-9499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2009019847
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number15-01311
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: