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NPI Code Detail

MEDICARE: MR. CHERIAN GEORGE MALIPURATHU RN, MSN,FNP-BC, PTA

MEDICARE: MR. CHERIAN GEORGE MALIPURATHU RN, MSN,FNP-BC, PTA
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
1225200000XPhysical Therapy Assistant401OK
2225200000XPhysical Therapy Assistant2001024018MO
3363LF0000XFamily Nurse Practitioner53-75922-092KS
4363LP0808XPsychiatric/Mental Health Nurse Practitioner2018012807MO
5163WM0705XMedical-Surgical Registered Nurse2004031658MO

General Provider Information

NPI Number : 1215126826
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CHERIAN GEORGE MALIPURATHU RN, MSN,FNP-BC, PTA
Provider Business Mailing Address
First Line : 210 NE TUDOR RD
Second Line :
City : LEES SUMMIT
State : MO
Zip : 64086-5696
Country : US
Telephone Number : 888-256-3814
Fax Number : 888-256-9054
Provider Business Practice Location Address
First Line : 1707 E 59TH TER
Second Line :
City : KANSAS CITY
State : MO
Zip : 64110-3549
Country : US
Telephone Number : 816-523-6562
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2007
Last Update Date : 04/08/2020

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