Individual
TEREASA LYNNETTE PICKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4801 COLLEGE BLVD, LEAWOOD, KS 66211-1628
(913) 956-2250
Mailing address
1000 CARONDELET DR, PROVIDER ENROLLMENT, KANSAS CITY, MO 64114
(816) 943-5744
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-01416
KS
Other
Enumeration date
09/24/2010
Last updated
10/30/2018
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