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NPI Code Detail

MEDICARE: HARRIET PEARSON MALLICOAT ARNP CNM

MEDICARE:   HARRIET PEARSON MALLICOAT  ARNP CNM
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
1363L00000XNurse Practitioner45064KS
2367A00000XAdvanced Practice Midwife64080KS
3363LF0000XFamily Nurse Practitioner034959MO
4367A00000XAdvanced Practice Midwife034959MO

General Provider Information

NPI Number : 1295706943
Entity Type Code : Individual
Provider Name (Legal Business Name) : HARRIET PEARSON MALLICOAT ARNP CNM
Provider Business Mailing Address
First Line : 24417 W 114TH ST
Second Line :
City : OLATHE
State : KS
Zip : 66061-7333
Country : US
Telephone Number : 913-780-1304
Fax Number :
Provider Business Practice Location Address
First Line : 545 E SANTA FE ST
Second Line :
City : OLATHE
State : KS
Zip : 66061-3462
Country : US
Telephone Number : 913-764-1662
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2006
Last Update Date : 01/08/2008

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Directions to “ HARRIET PEARSON MALLICOAT ARNP CNM” Practice Location

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