Healthcare Provider Details

I. General information

NPI: 1124399027
Provider Name (Legal Business Name): KELLY FERRARA SUIT M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2012
Last Update Date: 03/11/2020
Certification Date: 03/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF KANSAS HEALTH SYSTEM 2330 SHAWNEE MISSION PARKWAY, MS 5012
WESTWOOD KS
66205-5073
US

IV. Provider business mailing address

UNIVERSITY OF KANSAS HEALTH SYSTEM 2330 SHAWNEE MISSION PARKWAY, MS 5012
WESTWOOD KS
66205-5073
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-0640
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: