MEDICARE: KARLA DANIELA SEVILLA

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
1	374J00000X	Doula

General Provider Information

NPI Number	:	1346079084
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARLA DANIELA SEVILLA

Provider Business Mailing Address
First Line	:	8140 N THOMAS MEYERS DR APT J
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64118-9514
Country	:	US
Telephone Number	:	816-263-1912
Fax Number	:

Provider Business Practice Location Address
First Line	:	8140 N THOMAS MEYERS DR APT J
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64118-9514
Country	:	US
Telephone Number	:	816-263-1912
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2024
Last Update Date	:	07/31/2024

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