MEDICARE: KRISTEN STRIDE

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	363AM0700X	Medical Physician Assistant	2024023295	MO
2	363AM0700X	Medical Physician Assistant	15-02924	KS

General Provider Information

NPI Number	:	1902289218
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN STRIDE

Provider Business Mailing Address
First Line	:	4000 CAMBRIDGE ST # 3201
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 # MS 3021
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-1159
Country	:	US
Telephone Number	:	913-588-1227
Fax Number	:

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

Provider Enumeration Date	:	07/06/2015
Last Update Date	:	08/07/2024

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Directions to “ KRISTEN STRIDE ” Practice Location

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