Healthcare Provider Details

I. General information

NPI: 1649934340
Provider Name (Legal Business Name): CAITLIN AARON NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2021
Last Update Date: 10/28/2021
Certification Date: 09/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 SE BLUE PKWY
LEES SUMMIT MO
64063-1007
US

IV. Provider business mailing address

3600 W 73RD ST
PRAIRIE VILLAGE KS
66208-2903
US

V. Phone/Fax

Practice location:
  • Phone: 816-282-5000
  • Fax:
Mailing address:
  • Phone: 816-560-9899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2021041127
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: