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General NPI Number Information
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NPI Number | 1225162076
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Entity Type | Individual
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Provider Name | KRISTIN LEA GERNON L.M.S.W.
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Gender | Female
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 01/07/2011
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Provider Practice Location Address
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Address Line | 1223 MEADOWLARK LN
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City | KANSAS CITY
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State | KS
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Zip | 66102-1258
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Country | US
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Telephone | 913-890-7567
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Fax |
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Provider Business Mailing Address
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Address Line | 4130 OAK ST
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City | KANSAS CITY
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State | MO
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Zip | 64111-1615
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Country | US
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Telephone | 646-752-4054
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6220
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License Number State | KS
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