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General NPI Number Information
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NPI Number | 1477522399
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Entity Type | Organization
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Legal Business Name | NANCY B ISRAEL, MD, LLC
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 06/12/2008
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Provider Practice Location Address
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Address Line | 15144 PAWNEE CIR
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City | LEAWOOD
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State | KS
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Zip | 66224-3832
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Country | US
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Telephone | 913-681-5871
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Fax | 913-897-2166
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Provider Business Mailing Address
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Address Line | PO BOX 23563
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City | SHAWNEE MISSION
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State | KS
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Zip | 66283-0563
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Country | US
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Telephone | 913-248-9693
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Fax | 913-248-9383
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Authorized Official
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Title or Position | PRESIDENT
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Name | NANCY B ISRAEL
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Credential | MD
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Telephone | 913-681-5871
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 105698
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License Number State | MO
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