Doctor Name: | ALLISON O'BOYNICK SERRANO |
NPI Number: | 1164794368 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | 15-01464 |
Business Practice Address: | 9301 W 74th St Ste 225 Merriam, KS - 662042207 |
Business Phone Number: | 9138311003 |
Business Fax Number: | 9138314801 |
Mailing Address: | 9301 W 74th St, Ste 225 MERRIAM |
State: | KS |
Postal Code: | 662042207 |
Phone Number: | 9138311003 |
Fax Number: | |
NPI Enumeration Date: | 02/02/2012 |
NPI Last Update Date: | 01/27/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 15-01464 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |