Basic Information
Provider Information
NPI: 1336691369
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEMONS
FirstName: TERESA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6000 LAMAR AVE
Address2: SUITE 130
City: MISSION
State: KS
PostalCode: 662023234
CountryCode: US
TelephoneNumber: 9138264200
FaxNumber: 9138261589
Practice Location
Address1: 1125 W SPRUCE ST
Address2:  
City: OLATHE
State: KS
PostalCode: 660613123
CountryCode: US
TelephoneNumber: 9138264200
FaxNumber: 9138261589
Other Information
ProviderEnumerationDate: 10/25/2016
LastUpdateDate: 10/25/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X114021KSY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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