Healthcare Provider Details

I. General information

NPI: 1336275668
Provider Name (Legal Business Name): KATHRYN BELLE ESPINOZA COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10300 W 103RD ST STE 300 QUANTUM HEALTH PROFESSIONALS
OVERLAND PARK KS
66214-2658
US

IV. Provider business mailing address

4727 N WINCHESTER AVE
KANSAS CITY MO
64117-1575
US

V. Phone/Fax

Practice location:
  • Phone: 913-894-1910
  • Fax:
Mailing address:
  • Phone: 816-401-0430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number00642
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number004371
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: