MEDICARE: DIANNA LYNN MARAK ARNPC

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	363LF0000X	Family Nurse Practitioner	105747	MO
2	363LF0000X	Family Nurse Practitioner	45060	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	160549	OTHER	KS	BC/BS KS OUTREACH CLINICS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	29921019	OTHER	MO	BCBS KC

General Provider Information

NPI Number	:	1447209879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANNA LYNN MARAK ARNPC

Provider Business Mailing Address
First Line	:	20805 W 151ST ST STE 400
Second Line	:
City	:	OLATHE
State	:	KS
Zip	:	66061-7249
Country	:	US
Telephone Number	:	913-780-4900
Fax Number	:

Provider Business Practice Location Address
First Line	:	20805 W 151ST ST STE 400
Second Line	:
City	:	OLATHE
State	:	KS
Zip	:	66061-7249
Country	:	US
Telephone Number	:	913-780-4900
Fax Number	:	913-780-0949

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

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	07/21/2022

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