Provider Demographics
NPI:1225409634
Name:MANN, KATHLEEN (APRN)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:
Last Name:MANN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1962 W SURREY ST
Mailing Address - Street 2:MS 3016
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-8846
Mailing Address - Country:US
Mailing Address - Phone:913-588-6152
Mailing Address - Fax:913-588-0603
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:MS 3016
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160
Practice Address - Country:US
Practice Address - Phone:913-588-6152
Practice Address - Fax:913-588-0603
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-12
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS76943363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner