1821024688 NPI number — KERRI LYNN KEBERLEIN-LYNN ARNP, FNP-C

Table of content: KERRI LYNN KEBERLEIN-LYNN ARNP, FNP-C (NPI 1821024688)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821024688 NPI number — KERRI LYNN KEBERLEIN-LYNN ARNP, FNP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KEBERLEIN-LYNN
Provider First Name:
KERRI
Provider Middle Name:
LYNN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ARNP, FNP-C
Provider Gender Code:
F

Provider's Other Name Information

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

NPI Number Information

NPI Number:
1821024688
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/19/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2330 SHAWNEE MISSION PKWY
Provider Second Line Business Mailing Address:
MEDICAL ADMINISTRATIVE SERVICES OF KU MED, STE. 312
Provider Business Mailing Address City Name:
WESTWOOD
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66205-2005
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-588-9000
Provider Business Mailing Address Fax Number:
913-588-9822

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6420 N PROSPECT AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GLADSTONE
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64119
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-945-9700
Provider Business Practice Location Address Fax Number:
913-945-9707
Provider Enumeration Date:
06/24/2006

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:  44287 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: 154978 , 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)

  • Identifier: 500026194 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 610311 . This is a "FIRSTGUARD KUMW UC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 100250480F , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".




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