Provider Demographics
NPI:1366644346
Name:KAFKA, KATHLEEN KROMM (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:KROMM
Last Name:KAFKA
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 W. 109TH ST. SUITE 100
Mailing Address - Street 2:PLANNED PARENTHOOD OF KS & MID MO
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211
Mailing Address - Country:US
Mailing Address - Phone:913-345-4664
Mailing Address - Fax:913-345-2820
Practice Address - Street 1:4401 W. 109TH ST. SUITE 100
Practice Address - Street 2:PLANNED PARENTHOOD OF KS & MID MO
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211
Practice Address - Country:US
Practice Address - Phone:913-345-4664
Practice Address - Fax:913-345-2820
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0346594363LF0000X, 363LF0000X
KS14119988-062163W00000X
KS5375812062363L00000X
MO059889163W00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200963770AMedicaid
KS200963770BMedicaid
0346594-22OtherAPN CERTIFICATION
OHRX 07028OtherCERTIFICATE TO PRESCRIBE
0346594-22OtherAPN CERTIFICATION
OHRN 275822OtherRN LICENSE
KS200963770BMedicaid