Healthcare Provider Details

I. General information

NPI: 1548531106
Provider Name (Legal Business Name): CAROLYN JADE KAFER DVM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2012
Last Update Date: 01/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 SW US HIGHWAY 40
BLUE SPRINGS MO
64015-4611
US

IV. Provider business mailing address

1201 SW US HIGHWAY 40
BLUE SPRINGS MO
64015-4611
US

V. Phone/Fax

Practice location:
  • Phone: 816-229-1544
  • Fax: 816-228-9364
Mailing address:
  • Phone: 816-229-1544
  • Fax: 816-228-9364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number2011040267
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: