Doctor Name: | KAREN FERNENGEL |
NPI Number: | 1710159520 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 44969 |
Business Practice Address: | 5170 Roe Blvd Roeland Park, KS - 662052359 |
Business Phone Number: | 9134320110 |
Business Fax Number: | |
Mailing Address: | 5170 Roe Blvd, ROELAND PARK |
State: | KS |
Postal Code: | 662052359 |
Phone Number: | 9134320110 |
Fax Number: | |
NPI Enumeration Date: | 04/01/2008 |
NPI Last Update Date: | 05/07/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 44969 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |