MEDICARE: KATIE LYNN DENNIS M.D.

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	04-32977	KS

General Provider Information

NPI Number	:	1528190758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIE LYNN DENNIS M.D.

Provider Business Mailing Address
First Line	:	4000 CAMBRIDGE ST
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-8501
Country	:	US
Telephone Number	:	913-588-1227
Fax Number	:

Provider Business Practice Location Address
First Line	:	4000 CAMBRIDGE ST
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-7730
Country	:	US
Telephone Number	:	913-588-1227
Fax Number	:

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

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	09/12/2023

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