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General NPI Number Information
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NPI Number | 1902988199
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Entity Type | Individual
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Provider Name | KRISTEN M WOOTTON D.O.
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Gender | Female
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 11/17/2017
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Provider Practice Location Address
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Address Line | 4320 WORNALL RD MEDICAL PLAZA I, STE 336
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City | KANSAS CITY
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State | MO
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Zip | 64111-5941
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Country | US
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Telephone | 816-932-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 901 E. 104TH ST. MAILSTOP 400N
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City | KANSAS CITY
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State | MO
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Zip | 64111-9712
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Country | US
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Telephone | 816-502-8756
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Fax | 816-932-9670
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 05-30216
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 2000171368
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License Number State | MO
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