Provider Demographics
NPI:1326004540
Name:STIGGE, LAURA A (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:A
Last Name:STIGGE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 W 151ST ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-5348
Mailing Address - Country:US
Mailing Address - Phone:913-764-1125
Mailing Address - Fax:913-764-1186
Practice Address - Street 1:153 W 151ST ST
Practice Address - Street 2:SUITE 100
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-5348
Practice Address - Country:US
Practice Address - Phone:913-764-1125
Practice Address - Fax:913-764-1186
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-00501363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSP00236705OtherMEDICARE RAILROAD
KSJ41A567Medicare PIN