Provider Demographics
NPI:1740713247
Name:LAURSEN, DANIEL RYAN
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:RYAN
Last Name:LAURSEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10500 QUIVIRA RD
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66215-2306
Mailing Address - Country:US
Mailing Address - Phone:913-541-5000
Mailing Address - Fax:
Practice Address - Street 1:10500 QUIVIRA RD
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66215-2306
Practice Address - Country:US
Practice Address - Phone:913-541-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-11
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-42980207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine