Provider Demographics
NPI:1184978207
Name:ENGLERT, KAI THOMAS (PA)
Entity type:Individual
Prefix:
First Name:KAI
Middle Name:THOMAS
Last Name:ENGLERT
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:148 BETHANY DR
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66503-3086
Mailing Address - Country:US
Mailing Address - Phone:785-223-7847
Mailing Address - Fax:405-715-3325
Practice Address - Street 1:10250 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:PRATT
Practice Address - State:KS
Practice Address - Zip Code:67124-8195
Practice Address - Country:US
Practice Address - Phone:785-223-7847
Practice Address - Fax:405-715-3325
Is Sole Proprietor?:No
Enumeration Date:2012-10-29
Last Update Date:2023-11-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA088636363A00000X
NE2262363A00000X
CAPA56307363A00000X
MN13141363A00000X
KS15-01577363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant