MEDICARE: ISAAC CAIRO

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	163W00000X	Registered Nurse	139728	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7858615612	OTHER		PHONE NUMBER

General Provider Information

NPI Number	:	1851850341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ISAAC CAIRO

Provider Business Mailing Address
First Line	:	2303 N 74TH ST
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66109-2435
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2303 N 74TH ST
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66109-2435
Country	:	US
Telephone Number	:	785-861-5612
Fax Number	:

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

Provider Enumeration Date	:	03/14/2019
Last Update Date	:	03/14/2019

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Directions to “ ISAAC CAIRO ” Practice Location

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