Provider Demographics
NPI:1265528475
Name:STUEVE, KATHRYN ANNA (MD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:ANNA
Last Name:STUEVE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 N. RIVERSIDE RD.,
Mailing Address - Street 2:STE. G50
Mailing Address - City:ST JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64507-2553
Mailing Address - Country:US
Mailing Address - Phone:816-671-4888
Mailing Address - Fax:816-671-4890
Practice Address - Street 1:802 N. RIVERSIDE RD.,
Practice Address - Street 2:STE. G50
Practice Address - City:ST JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64507-2553
Practice Address - Country:US
Practice Address - Phone:816-671-4888
Practice Address - Fax:816-671-4890
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2017-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-7248208600000X
MO2009035748208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1265528475Medicaid
MOP00800174OtherRR MEDICARE
KS200630700AMedicaid
MOP00800174OtherRR MEDICARE