Healthcare Provider Details

I. General information

NPI: 1013355577
Provider Name (Legal Business Name): ERIN KELSEY KHAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN KELSEY WEBB MD

II. Dates (important events)

Enumeration Date: 06/06/2013
Last Update Date: 03/24/2021
Certification Date: 03/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 GILLHAM RD
KANSAS CITY MO
64108-4619
US

IV. Provider business mailing address

2401 GILLHAM RD
KANSAS CITY MO
64108-4619
US

V. Phone/Fax

Practice location:
  • Phone: 816-701-5200
  • Fax:
Mailing address:
  • Phone: 816-701-5200
  • Fax: 816-302-9939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDR0058289
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number01077049
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number2020027339
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: