Healthcare Provider Details
I. General information
NPI: 1700333473
Provider Name (Legal Business Name): KATE CHRISTINE PORAZZO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/09/2016
Last Update Date: 02/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8340 MISSION ROAD
PRAIRIE VILLAGE KS
66206-1339
US
IV. Provider business mailing address
8340 MISSION ROAD
PRAIRIE VILLAGE KS
66206-1339
US
V. Phone/Fax
- Phone: 913-642-2100
- Fax: 913-642-2127
- Phone: 913-642-2100
- Fax: 913-642-2127
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 2016014239 |
| License Number State | MO |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | 13-109663-081 |
| License Number State | KS |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | 2014022222 |
| License Number State | MO |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 53-77293-081 |
| License Number State | KS |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: