Provider Demographics
NPI:1659486181
Name:KASER, MARY ANNE (ARNP, BC)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ANNE
Last Name:KASER
Suffix:
Gender:F
Credentials:ARNP, BC
Other - Prefix:MRS
Other - First Name:MARY
Other - Middle Name:ANNE
Other - Last Name:BRUDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1600 E EVERGREEN ST
Mailing Address - Street 2:
Mailing Address - City:CAMERON
Mailing Address - State:MO
Mailing Address - Zip Code:64429-2400
Mailing Address - Country:US
Mailing Address - Phone:816-632-2101
Mailing Address - Fax:816-649-3383
Practice Address - Street 1:214 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PLATTSBURG
Practice Address - State:MO
Practice Address - Zip Code:64477-1238
Practice Address - Country:US
Practice Address - Phone:816-539-3366
Practice Address - Fax:816-539-2866
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003017718363LF0000X
KS46124363LF0000X
KS14-102738-021163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOX93000020Medicare PIN