Provider Demographics
NPI:1093457517
Name:ANJARD, KATHERINE ANNE POULOSE (MD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ANNE POULOSE
Last Name:ANJARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:ANNE
Other - Last Name:POULOSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6408 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66218-9067
Mailing Address - Country:US
Mailing Address - Phone:913-961-0140
Mailing Address - Fax:
Practice Address - Street 1:2101 CHARLOTTE ST STE 200
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-2765
Practice Address - Country:US
Practice Address - Phone:816-404-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-13
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program