Provider Demographics
NPI:1275663940
Name:WILMOT, KARLA D (RNC,WHNP,MSN)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:D
Last Name:WILMOT
Suffix:
Gender:F
Credentials:RNC,WHNP,MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19550 E 39TH ST S
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64057-2303
Mailing Address - Country:US
Mailing Address - Phone:816-350-1200
Mailing Address - Fax:
Practice Address - Street 1:19550 E 39TH ST S
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-2303
Practice Address - Country:US
Practice Address - Phone:816-350-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS44963363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS161052OtherBCBS OF KS PROVIDER ID
KS100643150AMedicaid
MO428056220Medicaid
KS110035OtherBCBS OF KS GRP ID