Provider Demographics
NPI:1326432410
Name:MCCANN, LAURIE (DO)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:MCCANN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10550 QUIVIRA RD STE 520
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66215-2307
Mailing Address - Country:US
Mailing Address - Phone:913-310-0482
Mailing Address - Fax:
Practice Address - Street 1:10550 QUIVIRA RD STE 520
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66215-2307
Practice Address - Country:US
Practice Address - Phone:913-310-0482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-26
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO.1707208000000X
MO20200165022080P0206X
390200000X
KS05-482542080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program