1083693717 NPI number — MRS. KATHERINE EILEEN CHRISTENSEN APRN - NP

Table of content: MRS. KATHERINE EILEEN CHRISTENSEN APRN - NP (NPI 1083693717)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083693717 NPI number — MRS. KATHERINE EILEEN CHRISTENSEN APRN - NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHRISTENSEN
Provider First Name:
KATHERINE
Provider Middle Name:
EILEEN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APRN - NP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SHANNON
Provider Other First Name:
KATIE
Provider Other Middle Name:
E
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1083693717
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/04/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4000 CAMBRIDGE ST STE G600
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KANSAS CITY
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66160-8501
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-588-9600
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3901 RAINBOW BLVD
Provider Second Line Business Practice Location Address:
STE G600
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66160-8500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-588-9600
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/11/2006

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: 363L00000X , with the licence number:  2001023150 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: 53-45804 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LA2200X , with the licence number: 53-45804 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 200369320B , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 36824015 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 925853 . This is a "FIRST GUARD MCO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1083693717 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200369320 A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 427445804 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".