Provider Demographics
NPI:1407098395
Name:BOYD, KARA LEIGH-LAWLESS (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KARA
Middle Name:LEIGH-LAWLESS
Last Name:BOYD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:LEIGH
Other - Last Name:LAWLESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3651 COLLEGE BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211
Mailing Address - Country:US
Mailing Address - Phone:913-319-7633
Mailing Address - Fax:913-253-1764
Practice Address - Street 1:3651 COLLEGE BOULEVARD
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211
Practice Address - Country:US
Practice Address - Phone:913-319-7633
Practice Address - Fax:913-253-1764
Is Sole Proprietor?:No
Enumeration Date:2009-03-24
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4383363AS0400X
AZ363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZP00816006OtherRAILROAD MEDICARE
AZ416580Medicaid
AZ416580Medicaid