=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356742431
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KARID LINNETTE NIEVES-BORRERO MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/09/2014
-----------------------------------------------------
Last Update Date | 03/07/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6530 TROOST AVE STE A
-----------------------------------------------------
City | KANSAS CITY
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64131-1301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 163-610-6708
-----------------------------------------------------
Fax | 816-444-6936
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6530 TROOST AVE STE A
-----------------------------------------------------
City | KANSAS CITY
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64131-1301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-361-0670
-----------------------------------------------------
Fax | 816-444-6936
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RN0300X
-----------------------------------------------------
Taxonomy Name | Nephrology Physician
-----------------------------------------------------
License Number | A156122
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RN0300X
-----------------------------------------------------
Taxonomy Name | Nephrology Physician
-----------------------------------------------------
License Number | 2021041699
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------