Individual
LARA KRISTIE KORAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108
(816) 234-3000
(816) 302-9939
Mailing address
2401 GILLHAM RD., PROVIDER ENROLLMENT, KANSAS CITY, MO 64108-4619
(816) 701-5200
(816) 302-9939
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
15900
TN
363LF0000X
Family Nurse Practitioner
Primary
2006023496
MO
363LF0000X
Family Nurse Practitioner
78156
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
426780003
—
MO
Enumeration date
08/04/2006
Last updated
06/20/2018
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