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NPI Code Detail

MEDICARE: DR. KATHLEEN R CITA M.D.

MEDICARE: DR. KATHLEEN R CITA 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
1208000000XPediatrics Physician2006004614MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982686903
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATHLEEN R CITA M.D.
Provider Business Mailing Address
First Line : 5840 GRAND AVE
Second Line :
City : KANSAS CITY
State : MO
Zip : 64113-2128
Country : US
Telephone Number : 816-569-6989
Fax Number :
Provider Business Practice Location Address
First Line : 501 NW BARRY RD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64155-2732
Country : US
Telephone Number : 816-413-4543
Fax Number : 816-413-2555
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2005
Last Update Date : 05/17/2012

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