Healthcare Provider Details

I. General information

NPI: 1285655415
Provider Name (Legal Business Name): MANDY M SANDER-PRATHER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MANDY M SANDER

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19600 E 39TH ST S
INDEPENDENCE MO
64057-2301
US

IV. Provider business mailing address

8717 W 110TH ST STE 600
OVERLAND PARK KS
66210-2126
US

V. Phone/Fax

Practice location:
  • Phone: 816-698-7000
  • Fax: 913-428-2951
Mailing address:
  • Phone: 913-428-2900
  • Fax: 913-428-2951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number2011001622
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0431940
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: