Individual
NATALIE PARE DISETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3000
(816) 302-9939
Mailing address
2401 GILLHAM RD, PROVIDER ENROLLMENT DEPARTMENT, KANSAS CITY, MO 64108-4619
(816) 701-5200
(816) 302-9939
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2020016983
MO
152W00000X
Optometrist
2129
KS
152WP0200X
Pediatric Optometrist
Primary
2020016983
MO
152WP0200X
Pediatric Optometrist
2129
KS
Other
Enumeration date
04/30/2020
Last updated
03/06/2026
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