Individual
BREEANNA FEAUTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5721 W 119TH ST, OVERLAND PARK, KS 66209-3722
(913) 498-6000
Mailing address
8900 ENSLEY LN, LEAWOOD, KS 66206-1742
(712) 389-5043
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PENDING
KS
Other
Enumeration date
07/02/2012
Last updated
07/21/2022
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