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Individual

MRS. EMILY SUZANNE MATHIESEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
21120 W 152ND ST STE 201, OLATHE, KS 66061
(913) 491-4020
(913) 491-4725
Mailing address
9301 W 74TH ST STE 320, OVERLAND PARK, KS 66204-2207
(913) 491-4020
(913) 491-4725

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
04-39438
KS
174400000X
Specialist
2014015770
MO

Other

Enumeration date
04/01/2010
Last updated
03/22/2019
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