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NPI Code Detail

MEDICARE: DR. ELIZABETH ANN FOSSEY PH.D.

MEDICARE: DR. ELIZABETH ANN FOSSEY PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist01348MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
121479045OTHERMOBLUE CROSS/BLUE SHIELD

General Provider Information

NPI Number : 1205811429
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELIZABETH ANN FOSSEY PH.D.
Provider Business Mailing Address
First Line : 3100 NE 83RD ST
Second Line : SUITE 2350
City : KANSAS CITY
State : MO
Zip : 64119-4400
Country : US
Telephone Number : 816-436-1721
Fax Number : 816-436-1180
Provider Business Practice Location Address
First Line : 3100 NE 83RD ST
Second Line : SUITE 2350
City : KANSAS CITY
State : MO
Zip : 64119-4400
Country : US
Telephone Number : 816-436-1721
Fax Number : 816-436-1180
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2005
Last Update Date : 07/08/2007

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