Provider Demographics
NPI:1811192529
Name:ABRAHAM, BETH ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:ANNE
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:21 N. 12TH ST, SUITE 300
Mailing Address - Street 2:TURNER HOUSE CHILDREN'S CLINIC
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66102
Mailing Address - Country:US
Mailing Address - Phone:913-342-2552
Mailing Address - Fax:913-342-3220
Practice Address - Street 1:21 N. 12TH ST, SUITE 300
Practice Address - Street 2:TURNER HOUSE CHILDREN'S CLINIC
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66102
Practice Address - Country:US
Practice Address - Phone:913-342-2552
Practice Address - Fax:913-342-3220
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN43464208000000X
KS434356208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200681560AMedicaid