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Individual

SUSAN K FAJARDO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
R.P.A.C.

Contact information

Practice address
6345 LONG ST, SHAWNEE, KS 66216-2559
(913) 631-6400
(913) 631-6868
Mailing address
PO BOX 12066, KANSAS CITY, KS 66112-0066
(913) 299-4966
(913) 299-4205

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-00554
KS

Other

Enumeration date
08/05/2006
Last updated
09/16/2024
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