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NPI Code Detail

MEDICARE: KATHERINE ANNE BONESSA CPNP-AC

MEDICARE: KATHERINE ANNE BONESSA CPNP-AC
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
1363LP0222XCritical Care Pediatric Nurse Practitioner77298KS
2363LP0222XCritical Care Pediatric Nurse Practitioner2016021264MO

General Provider Information

NPI Number : 1215480272
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE ANNE BONESSA CPNP-AC
Provider Business Mailing Address
First Line : 2401 GILLHAM RD
Second Line : FETAL CARDIOLOGY: 3RD FLOOR HALL TOWER
City : KANSAS CITY
State : MO
Zip : 64108-4619
Country : US
Telephone Number : 816-234-3209
Fax Number :
Provider Business Practice Location Address
First Line : 2401 GILLHAM RD
Second Line : FETAL CARDIOLOGY: 3RD FLOOR HALL TOWER
City : KANSAS CITY
State : MO
Zip : 64108-4619
Country : US
Telephone Number : 816-234-3209
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2016
Last Update Date : 01/08/2018

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Directions to “ KATHERINE ANNE BONESSA CPNP-AC” Practice Location

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