Basic Information
| Provider Information | |||||||||
| NPI: | 1730715178 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TITUS | ||||||||
| FirstName: | ANNA | ||||||||
| MiddleName: | ALEXANDRA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9702 W 49TH TER | ||||||||
| Address2: | |||||||||
| City: | MERRIAM | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662034808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9132750728 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4000 CAMBRIDGE ST | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 661608501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9135881227 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/17/2020 | ||||||||
| LastUpdateDate: | 03/17/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WM0705X | 13127727092 | KS | Y | Nursing Service Providers | Registered Nurse | Medical-Surgical |
No ID Information.