Provider Demographics
NPI:1073722799
Name:KUIPER, MALANA K (MD)
Entity Type:Individual
Prefix:
First Name:MALANA
Middle Name:K
Last Name:KUIPER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5401 COLLEGE BLVD
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1923
Mailing Address - Country:US
Mailing Address - Phone:913-825-3627
Mailing Address - Fax:913-948-9128
Practice Address - Street 1:5401 COLLEGE BLVD
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1923
Practice Address - Country:US
Practice Address - Phone:913-825-3627
Practice Address - Fax:913-948-9128
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS33011208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200565350BMedicaid