Healthcare Provider Details

I. General information

NPI: 1144339037
Provider Name (Legal Business Name): LISA S GILMER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7301 MISSION RD STE 350
PRAIRIE VILLAGE KS
66208-3075
US

IV. Provider business mailing address

2106 OLATHE BLVD MS 4004
KANSAS CITY KS
66160-7816
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-6300
  • Fax: 913-274-3515
Mailing address:
  • Phone: 913-588-6300
  • Fax: 913-274-3515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number04-27032
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: