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Individual

ALLISON O'BOYNICK SERRANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
9301 W 74TH ST, STE 225, MERRIAM, KS 66204-2207
(913) 831-1003
(913) 831-4801
Mailing address
9301 W 74TH ST, STE 225, MERRIAM, KS 66204-2207
(913) 831-1003

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
15-01464
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P01105744
RR MEDICARE
MO
Enumeration date
02/02/2012
Last updated
01/27/2014
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