Provider Demographics
NPI:1225074461
Name:CHARTRAND, KATHRYN P (DO)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:P
Last Name:CHARTRAND
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15435 W 134TH PL
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-6135
Mailing Address - Country:US
Mailing Address - Phone:913-780-0030
Mailing Address - Fax:913-782-2924
Practice Address - Street 1:15435 W 134TH PL
Practice Address - Street 2:SUITE 101
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-6135
Practice Address - Country:US
Practice Address - Phone:913-780-0030
Practice Address - Fax:913-782-2924
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2014-12-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS0520604207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100229820AMedicaid
KS0336658DMedicare ID - Type Unspecified
KS100229820AMedicaid