Healthcare Provider Details

I. General information

NPI: 1376705624
Provider Name (Legal Business Name): REBECCA K BURGER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: REBECCA S KRISS MD

II. Dates (important events)

Enumeration Date: 06/27/2008
Last Update Date: 11/05/2011
Certification Date:
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: 816-234-3665
  • Fax:
Mailing address:
  • Phone: 816-234-3665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0116020745
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License Number2011010500
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License Number9407798
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: