1194701235 NPI number — MS. SHIRLEY WARING

Table of content: MS. SHIRLEY WARING (NPI 1194701235)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194701235 NPI number — MS. SHIRLEY WARING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WARING
Provider First Name:
SHIRLEY
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194701235
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4726 W 78TH TER
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PRAIRIE VILLAGE
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66208-4413
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-710-2040
Provider Business Mailing Address Fax Number:
913-766-1916

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11111 NALL AVE
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
LEAWOOD
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66211-1620
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-710-2040
Provider Business Practice Location Address Fax Number:
913-766-1916
Provider Enumeration Date:
12/20/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  2000150518 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 494866924 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com