Provider Demographics
NPI:1881850659
Name:DANIELS, KERRY M (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KERRY
Middle Name:M
Last Name:DANIELS
Suffix:
Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:2200 SW 6TH AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1707
Mailing Address - Country:US
Mailing Address - Phone:785-354-8518
Mailing Address - Fax:785-354-0292
Practice Address - Street 1:801 N MUR LEN RD STE 112
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1794
Practice Address - Country:US
Practice Address - Phone:913-738-8033
Practice Address - Fax:913-738-8034
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2019-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIAMD-326363A00000X
KS15-01696363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant