MEDICARE: ALEXIS KANE

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	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1962210385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIS KANE

Provider Business Mailing Address
First Line	:	2520 W 39TH AVE APT A
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66103-2836
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2520 W 39TH AVE APT A
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66103-2836
Country	:	US
Telephone Number	:	479-685-2086
Fax Number	:

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

Provider Enumeration Date	:	12/19/2024
Last Update Date	:	12/19/2024

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Directions to “ ALEXIS KANE ” Practice Location

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