Individual
MARY FEDERICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MARY WILLARD
Contact information
Practice address
16261 W 156TH TER, OLATHE, KS 66062-3865
(816) 804-4714
Mailing address
16261 W 156TH TER, OLATHE, KS 66062-3865
(816) 804-4714
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2004003180
MO
164W00000X
Licensed Practical Nurse
24-32964-082
KS
Other
Enumeration date
04/20/2009
Last updated
04/20/2009
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