Doctor Name: | KAREN W LONG |
NPI Number: | 1134146137 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MMS-PA-C |
License Number: | PA18051 |
Business Practice Address: | 2750 Clay Edwards Dr Suite 410 North Kansas City, MO - 641163237 |
Business Phone Number: | 8164718114 |
Business Fax Number: | 8168425342 |
Mailing Address: | 2750 Clay Edwards Dr, Suite 410 NORTH KANSAS CITY |
State: | MO |
Postal Code: | 641163237 |
Phone Number: | 8164718114 |
Fax Number: | 8168425342 |
NPI Enumeration Date: | 07/16/2006 |
NPI Last Update Date: | 07/16/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA18051 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |