=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356216303
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MERON KUNARD
-----------------------------------------------------
Gender |
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/08/2025
-----------------------------------------------------
Last Update Date | 10/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5675 ROE BLVD
-----------------------------------------------------
City | ROELAND PARK
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66205-2515
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-432-2080
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6143 HEMLOCK ST
-----------------------------------------------------
City | MERRIAM
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66202
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-755-5278
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 53-84855-051
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------