Individual
MS. STEPHANIE LYNN CALDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
7405 RENNER ROAD, SHAWNEE, KS 66217
(913) 588-6100
(913) 588-8186
Mailing address
3901 RAINBOW BLVD, MS 3017, KANSAS CITY, KS 66160
(913) 588-6100
(913) 588-8186
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15-00918
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1060213
NCCPA
—
05
—
200634930
—
KS
Enumeration date
12/12/2006
Last updated
03/19/2010
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