1558598219 NPI number — KRISTY KAY ROBINSON PTA

Table of content: KRISTY KAY ROBINSON PTA (NPI 1558598219)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558598219 NPI number — KRISTY KAY ROBINSON PTA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROBINSON
Provider First Name:
KRISTY
Provider Middle Name:
KAY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PTA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KENNEDY
Provider Other First Name:
KRISTY
Provider Other Middle Name:
KAY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PTA
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1558598219
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/19/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6405 METCALF AVE
Provider Second Line Business Mailing Address:
SUITE 220
Provider Business Mailing Address City Name:
OVERLAND PARK
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66202-3931
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-831-2721
Provider Business Mailing Address Fax Number:
913-384-0127

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1931 BURLINGTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64116-3407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-831-2721
Provider Business Practice Location Address Fax Number:
913-384-0127
Provider Enumeration Date:
06/19/2009

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: 225200000X , with the licence number:  2003019568 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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