Provider Demographics
NPI:1821489808
Name:PFANNENSTIEL, KAYLA ANN (APRN)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:ANN
Last Name:PFANNENSTIEL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5417 N 102ND ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66109-8610
Mailing Address - Country:US
Mailing Address - Phone:785-477-0525
Mailing Address - Fax:
Practice Address - Street 1:2330 SHAWNEE MISSION PKWY
Practice Address - Street 2:SUITE 3305
Practice Address - City:WESTWOOD
Practice Address - State:KS
Practice Address - Zip Code:66205-2005
Practice Address - Country:US
Practice Address - Phone:913-588-9821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-11
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-76684-012363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS13107216012OtherKANSAS RN LICENSE
MO2013031822OtherMISSOURI RN LICENSE