Provider Demographics
NPI:1578690202
Name:OLBERDING, KARMEN M (ARNP)
Entity Type:Individual
Prefix:
First Name:KARMEN
Middle Name:M
Last Name:OLBERDING
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2370 VINTAGE CT
Mailing Address - Street 2:
Mailing Address - City:EXCELSIOR SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64024-8011
Mailing Address - Country:US
Mailing Address - Phone:816-630-2032
Mailing Address - Fax:816-630-2028
Practice Address - Street 1:2370 VINTAGE CT
Practice Address - Street 2:
Practice Address - City:EXCELSIOR SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64024-8011
Practice Address - Country:US
Practice Address - Phone:816-630-2032
Practice Address - Fax:816-630-2028
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO154847363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1578690202Medicaid
MOP01193407OtherMEDICARE RAILROAD
MOMA4170021OtherMEDICARE PTAN
MO1578690202Medicaid