Provider Demographics
NPI:1760440697
Name:GENOVESE, ANN CHRISTINE (MD)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:CHRISTINE
Last Name:GENOVESE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 411851
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64141-1851
Mailing Address - Country:US
Mailing Address - Phone:816-404-1000
Mailing Address - Fax:816-404-5318
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-0001
Practice Address - Country:US
Practice Address - Phone:816-404-1000
Practice Address - Fax:816-404-5318
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR1P702084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1559994OtherUNITED HEALTHCARE
MO206883035Medicaid
MO176914OtherHEALTHLINK
MO171271OtherBLUE SHIELD/BLUE CHOICE
MO260052103OtherRR MEDICARE
MO2068830365Medicaid
F21481Medicare UPIN
MO2068830365Medicaid
MO171271OtherBLUE SHIELD/BLUE CHOICE