Healthcare Provider Details

I. General information

NPI: 1932618857
Provider Name (Legal Business Name): MEERA MITCHELLE CLYTONE MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 SHAWNEE MISSION PKWY
WESTWOOD KS
66205-2005
US

IV. Provider business mailing address

2330 SHAWNEE MISSION PKWY, MS 5012 UNIVERSITY OF KANSAS CANCER
WESTWOOD KS
66205-2005
US

V. Phone/Fax

Practice location:
  • Phone: 913-945-5565
  • Fax: 913-945-5959
Mailing address:
  • Phone: 913-945-5565
  • Fax: 913-945-5959

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: