Provider Demographics
NPI:1427407774
Name:GERMANO, KALLY
Entity Type:Individual
Prefix:
First Name:KALLY
Middle Name:
Last Name:GERMANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13121 BUENA VISTA ST
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66209-4145
Mailing Address - Country:US
Mailing Address - Phone:816-807-3280
Mailing Address - Fax:
Practice Address - Street 1:13121 BUENA VISTA ST
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66209-4145
Practice Address - Country:US
Practice Address - Phone:816-807-3280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist