1518994755 NPI number — DEBORAH PETTY RN MSN ARNP CCRN

Table of content: DR. MOLLY KATHLEEN HOWLETT DO (NPI 1295901783)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518994755 NPI number — DEBORAH PETTY RN MSN ARNP CCRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PETTY
Provider First Name:
DEBORAH
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN MSN ARNP CCRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MACKISH
Provider Other First Name:
DEBORAH
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1518994755
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/31/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20805 W 151ST ST
Provider Second Line Business Mailing Address:
BLDG 2 STE 400
Provider Business Mailing Address City Name:
OLATHE
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66061-5353
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-780-4900
Provider Business Mailing Address Fax Number:
913-780-0949

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20805 W 151ST ST
Provider Second Line Business Practice Location Address:
BLDG 2 STE 400
Provider Business Practice Location Address City Name:
OLATHE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66061-5353
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-780-4900
Provider Business Practice Location Address Fax Number:
913-780-0949
Provider Enumeration Date:
06/26/2006

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:  74827 , 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)





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