=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578690202
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KARMEN M OLBERDING ARNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/28/2007
-----------------------------------------------------
Last Update Date | 10/24/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2370 VINTAGE CT
-----------------------------------------------------
City | EXCELSIOR SPRINGS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64024-8011
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-630-2032
-----------------------------------------------------
Fax | 816-630-2028
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2370 VINTAGE CT
-----------------------------------------------------
City | EXCELSIOR SPRINGS
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64024-8011
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-630-2032
-----------------------------------------------------
Fax | 816-630-2028
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | 154847
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------