Provider Demographics
NPI:1568573103
Name:CARAWAY, JOSEPH (APRN)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:CARAWAY
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 N OAK TRFY
Mailing Address - Street 2:STE 100
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64118
Mailing Address - Country:US
Mailing Address - Phone:816-453-6200
Mailing Address - Fax:816-455-0595
Practice Address - Street 1:5400 N OAK TRFY
Practice Address - Street 2:STE 100
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64118-6489
Practice Address - Country:US
Practice Address - Phone:816-453-6200
Practice Address - Fax:816-455-0595
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO070510363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOB173567Medicare ID - Type Unspecified
R63430Medicare UPIN