Provider Demographics
NPI:1861673675
Name:MCCLERNON, KATHERINE PIERCE (ARNP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:PIERCE
Last Name:MCCLERNON
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 1:3901 RAINBOW BLVD.
Mailing Address - Street 2:MAILSTOP 4015
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-7351
Mailing Address - Country:US
Mailing Address - Phone:913-588-6400
Mailing Address - Fax:913-588-6414
Practice Address - Street 1:3901 RAINBOW BLVD.
Practice Address - Street 2:MAILSTOP 4015
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-7351
Practice Address - Country:US
Practice Address - Phone:913-588-6400
Practice Address - Fax:913-588-6414
Is Sole Proprietor?:No
Enumeration Date:2007-11-20
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45994363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health