Doctor Name: | KATHERINE LYNN PERAUD |
NPI Number: | 1063457430 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DO |
License Number: | 2005018539 |
Business Practice Address: | 4401 Wornall Rd Kansas City, MO - 641113220 |
Business Phone Number: | 8169322171 |
Business Fax Number: | |
Mailing Address: | Po Box 78009, SAINT LOUIS |
State: | MO |
Postal Code: | 631788009 |
Phone Number: | 8668987142 |
Fax Number: | 6169759824 |
NPI Enumeration Date: | 06/18/2006 |
NPI Last Update Date: | 10/15/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 2005018539 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MO |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |