Basic Information
Provider Information
NPI: 1174915946
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROMI
FirstName: SARA
MiddleName:  
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Mailing Information
Address1: 901 E. 104TH ST
Address2: MAILSTOP 400N
City: KANSAS CITY
State: MO
PostalCode: 641319712
CountryCode: US
TelephoneNumber: 8165027104
FaxNumber: 8169329670
Practice Location
Address1: 4061 INDIAN CREEK PKWY
Address2:  
City: OVERLAND PARK
State: KS
PostalCode: 662074030
CountryCode: US
TelephoneNumber: 9133177990
FaxNumber: 9133177018
Other Information
ProviderEnumerationDate: 03/03/2015
LastUpdateDate: 02/23/2018
NPIDeactivationReasonCode:  
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NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
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NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XTMP 150694KSN Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
363LF0000X76739KSY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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