Individual
CARRIE WIXSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4510 BELLEVIEW AVE STE 102, KANSAS CITY, MO 64111-3538
(816) 518-7409
Mailing address
21947 W 97TH TER, LENEXA, KS 66220-3761
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
15-01229
KS
363A00000X
Physician Assistant
2022029622
MO
363A00000X
Physician Assistant
Primary
T-01762
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1588842678
NPI
—
Enumeration date
01/31/2008
Last updated
05/01/2026
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