Individual
KENNETH DAVID KINNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
120 NE SAINT LUKES BLVD STE 200, LEES SUMMIT, MO 64086
(816) 246-4302
(816) 246-9493
Mailing address
120 NE SAINT LUKES BLVD STE 200, LEES SUMMIT, MO 64086-6011
(816) 246-4302
(816) 246-9493
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
15-00968
KS
363A00000X
Physician Assistant
Primary
2008021981
MO
363AS0400X
Surgical Physician Assistant
15-00968
KS
363AS0400X
Surgical Physician Assistant
2008021981
MO
Other
Enumeration date
12/12/2006
Last updated
04/09/2019
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