Healthcare Provider Details

I. General information

NPI: 1992630149
Provider Name (Legal Business Name): HALA ABU-JAISH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 CARONDELET DRIVE
KANSAS CITY MO
64114-4673
US

IV. Provider business mailing address

1000 CARONDELET DRIVE
KANSAS CITY MO
64114-4673
US

V. Phone/Fax

Practice location:
  • Phone: 816-943-4700
  • Fax:
Mailing address:
  • Phone: 816-943-7604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2026033124
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: