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NPI Code Detail

MEDICARE: JUANITTA OWUSU ABORAH PA-C

MEDICARE: JUANITTA OWUSU ABORAH PA-C
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
1363A00000XPhysician Assistant6519MA
2363A00000XPhysician Assistant55683CA
3363A00000XPhysician Assistant2020034329MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12020034329OTHERMOSTATE LICENSE

General Provider Information

NPI Number : 1225509334
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUANITTA OWUSU ABORAH PA-C
Provider Business Mailing Address
First Line : 3027 PROSPECT AVE
Second Line :
City : KANSAS CITY
State : MO
Zip : 64128-1530
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3027 PROSPECT AVE
Second Line :
City : KANSAS CITY
State : MO
Zip : 64128-1530
Country : US
Telephone Number : 816-861-6500
Fax Number : 816-861-6503
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2018
Last Update Date : 10/14/2020

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Directions to “ JUANITTA OWUSU ABORAH PA-C” Practice Location

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