Provider Demographics
NPI:1982609459
Name:PIEKARSKI, CONNIE J (ARNP)
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:J
Last Name:PIEKARSKI
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7527 STATE AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66112-2815
Mailing Address - Country:US
Mailing Address - Phone:913-335-6986
Mailing Address - Fax:855-446-7151
Practice Address - Street 1:7527 STATE AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112-2815
Practice Address - Country:US
Practice Address - Phone:913-335-6986
Practice Address - Fax:855-446-7151
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS44822363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSF208608Medicare PIN
KSS65427Medicare UPIN
KSF200000Medicare PIN