Provider Demographics
NPI:1568407674
Name:DUBOIS, KARA D (CNM)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:D
Last Name:DUBOIS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9710 ROSEHILL RD
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-1414
Mailing Address - Country:US
Mailing Address - Phone:913-544-2560
Mailing Address - Fax:888-796-4551
Practice Address - Street 1:9710 ROSEHILL RD
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215
Practice Address - Country:US
Practice Address - Phone:913-544-2560
Practice Address - Fax:888-796-4551
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS64093363LP2300X, 367A00000X
MO153157363LP2300X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200327070AMedicaid
KS200327070AMedicaid
KSA22D890Medicare ID - Type Unspecified