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Individual

SARA ELIZABETH CROSS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
9100 W 74TH ST, SHAWNEE MISSION, KS 66204-4004
(913) 676-2214
Mailing address
9100 W 74TH ST, SHAWNEE MISSION, KS 66204-4004
(913) 676-2214

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2005016345
MO
207P00000X
Emergency Medicine Physician
Primary
2008014373
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1821148123
MO
05
2000616950B
KS
05
200616950A
KS
01
42646016
BCBS KC GROUP 30492021
KS
01
42646026
BCBS KC GROUP 01674018
KS
01
P00738054
RR MEDICARE GROUP CG8899
KS
Enumeration date
01/11/2007
Last updated
06/30/2021
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