Provider Demographics
NPI:1144297367
Name:DARNELL, KATHERINE FRAZIER (FNP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:FRAZIER
Last Name:DARNELL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 803886
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-3886
Mailing Address - Country:US
Mailing Address - Phone:816-307-4893
Mailing Address - Fax:816-307-4893
Practice Address - Street 1:2303 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-4954
Practice Address - Country:US
Practice Address - Phone:816-232-6818
Practice Address - Fax:816-232-6823
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO096828363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO423404151Medicaid
F29B300AMedicare ID - Type Unspecified
P39549Medicare UPIN