Individual
NIMMY MATHEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4400 NW BARRY RD, KANSAS CITY, MO 64154-1606
(816) 587-8018
Mailing address
10221 W 126TH TER, OVERLAND PARK, KS 66213-1887
(405) 315-8175
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2018031234
MO
Other
Enumeration date
12/01/2020
Last updated
12/01/2020
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