Organization
KANSAS CITY INTERNAL MEDICINE PA
Active
Organization
KANSAS CITY INTERNAL MEDICINE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN A HANSEN MBA, FACMPE (CEO)
(913) 319-7303
Entity
Organization
Contact information
Practice address
12140 NALL AVE, SUITE 100, OVERLAND PARK, KS 66209-2504
(913) 451-8500
(913) 451-1754
Mailing address
12140 NALL AVE, SUITE 100, OVERLAND PARK, KS 66209-2504
(913) 451-8500
(913) 451-1754
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
111706
MO
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
103093
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200305470
—
KS
05
—
506936400
—
MO
Enumeration date
07/24/2006
Last updated
10/23/2014
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