Healthcare Provider Details

I. General information

NPI: 1396432845
Provider Name (Legal Business Name): KAYDEN ANNE CARTER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2023
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 OTTAWA RD
NEODESHA KS
66757-1897
US

IV. Provider business mailing address

2600 OTTAWA RD
NEODESHA KS
66757-1897
US

V. Phone/Fax

Practice location:
  • Phone: 620-325-2611
  • Fax: 605-755-4012
Mailing address:
  • Phone: 620-325-2611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number04-54024
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: