Healthcare Provider Details
I. General information
NPI: 1700396298
Provider Name (Legal Business Name): LANA KAY FOUST CPBMT, OPA-C, OTC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/10/2017
Last Update Date: 10/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3429 HARRISON ST # 1N
KANSAS CITY MO
64109-2912
US
IV. Provider business mailing address
3429 HARRISON ST # 1N
KANSAS CITY MO
64109-2912
US
V. Phone/Fax
- Phone: 913-909-8422
- Fax:
- Phone: 913-909-8422
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XX0801X |
| Taxonomy | Orthopaedic Trauma Physician |
| License Number | 12-0204 |
| License Number State | MO |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225500000X |
| Taxonomy | Respiratory/Developmental/Rehabilitative Specialist/Technologist |
| License Number | LKFKCMO2016PBMT |
| License Number State | MO |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 246RP1900X |
| Taxonomy | Phlebotomy Technician |
| License Number | 24389-PT05 |
| License Number State | MO |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | 12-0204 |
| License Number State | KS |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 246ZX2200X |
| Taxonomy | Orthopedic Assistant |
| License Number | 12-204 |
| License Number State | KS |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: