Individual
KIMRA ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
R1P51
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100027400A
—
OK
05
—
100125890B
—
KS
01
—
149422
ANTHEM
MO
05
—
203010707
—
MO
Enumeration date
07/03/2006
Last updated
03/07/2025
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