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General NPI Number Information
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NPI Number | 1659026060
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Entity Type | Individual
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Provider Name | SARA KUSH
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Gender | Female
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Dates
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Enumeration Date | 02/14/2022
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Last Update Date | 02/14/2022
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Provider Practice Location Address
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Address Line | 9666 QUIVIRA RD
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City | LENEXA
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State | KS
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Zip | 66215-1669
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Country | US
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Telephone | 913-871-0841
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Fax |
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Provider Business Mailing Address
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Address Line | 9633 WOODSON DR
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City | OVERLAND PARK
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State | KS
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Zip | 66207-2843
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Country | US
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Telephone | 316-214-7785
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 53-80912-041
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License Number State | KS
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