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General NPI Number Information
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NPI Number | 1104151307
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Entity Type | Individual
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Provider Name | KIMBERLY DISHMAN WHNP
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Gender | Female
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Dates
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Enumeration Date | 10/06/2009
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Last Update Date | 08/06/2014
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Provider Practice Location Address
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Address Line | 407 S CLAIRBORNE RD STE 104
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City | OLATHE
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State | KS
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Zip | 66062-1744
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Country | US
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Telephone | 913-648-2266
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Fax |
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Provider Business Mailing Address
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Address Line | 5811 W 78TH TER
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City | PRAIRIE VILLAGE
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State | KS
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Zip | 66208-4622
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Country | US
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Telephone | 773-419-9214
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 209-007802
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License Number State | IL
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