KATHLEEN D MAMMEN APRN FNP BC NPI 1114948627

NPI Information

NPI: 1114948627
Provider Name: KATHLEEN D MAMMEN, APRN FNP BC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
825 EUCLID AVE
KANSAS CITY, MO
ZIP 64124
Phone: (816) 889-4614
Get Directions

Kathleen D Mammen, APRN FNP BC is a family nurse practitioner in Kansas City, MO. Kathleen D Mammen, APRN FNP BC NPI is 1114948627. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

825 EUCLID AVE
KANSAS CITY, MO
ZIP 64124-323
Phone: (816) 889-4614
Fax: (816) 889-4847

The NPI 1114948627 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/21/2006 and was last updated on 1/16/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	2005017142	MISSOURI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3046869 00	MEDICAID	FLORIDA
2	421441304	MEDICAID	MISSOURI
3	P297966850	MEDICARE ID-TYPE UNSPECIFIED	SOUTH CAROLINA
4	C16E724	OTHER	MISSOURI	MEDICARE B WHEATLANDS
5	P29796	MEDICARE UPIN	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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