Provider Demographics
NPI:1003207820
Name:ALLINDER, MARY KATHRYN (NP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:KATHRYN
Last Name:ALLINDER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 NW ENGLEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:GLADSTONE
Mailing Address - State:MO
Mailing Address - Zip Code:64118-4054
Mailing Address - Country:US
Mailing Address - Phone:816-453-1818
Mailing Address - Fax:913-495-3712
Practice Address - Street 1:101 NW ENGLEWOOD RD
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:MO
Practice Address - Zip Code:64118-4054
Practice Address - Country:US
Practice Address - Phone:816-453-1818
Practice Address - Fax:913-495-3712
Is Sole Proprietor?:No
Enumeration Date:2015-02-16
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOF0215212363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily