Provider Demographics
NPI:1134529589
Name:SUNDERMAN, CAITLIN JANELLE (PA-C)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:JANELLE
Last Name:SUNDERMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MRS
Other - First Name:CAITLIN
Other - Middle Name:JANELLE
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1004 CARONDELET DRIVE
Mailing Address - Street 2:SUITE 330
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114
Mailing Address - Country:US
Mailing Address - Phone:816-941-6400
Mailing Address - Fax:816-941-6404
Practice Address - Street 1:1004 CARONDELET DRIVE
Practice Address - Street 2:SUITE 330
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114
Practice Address - Country:US
Practice Address - Phone:816-941-6400
Practice Address - Fax:816-941-6404
Is Sole Proprietor?:No
Enumeration Date:2014-09-03
Last Update Date:2017-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014025935363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant