Individual
DR. TRISHA PROSSICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
153 W 151ST STREET, SUITE 100, OLATHE, KS 66061
(913) 764-1125
(913) 764-1186
Mailing address
153 W 151ST STREET, SUITE 100, OLATHE, KS 66061-5300
(913) 764-1125
(913) 764-1186
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
04-31231
KS
207NS0135X
Procedural Dermatology Physician
0431231
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00456767
RR MEDICARE
—
Enumeration date
11/30/2005
Last updated
01/12/2017
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