Basic Information
| Provider Information | |||||||||
| NPI: | 1265528475 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STUEVE | ||||||||
| FirstName: | KATHRYN | ||||||||
| MiddleName: | ANNA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 802 N. RIVERSIDE RD., | ||||||||
| Address2: | STE. G50 | ||||||||
| City: | ST JOSEPH | ||||||||
| State: | MO | ||||||||
| PostalCode: | 645072553 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8166714888 | ||||||||
| FaxNumber: | 8166714890 | ||||||||
| Practice Location | |||||||||
| Address1: | 802 N. RIVERSIDE RD., | ||||||||
| Address2: | STE. G50 | ||||||||
| City: | ST JOSEPH | ||||||||
| State: | MO | ||||||||
| PostalCode: | 645072553 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8166714888 | ||||||||
| FaxNumber: | 8166714890 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2006 | ||||||||
| LastUpdateDate: | 11/22/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | R-7248 | IA | Y | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 2009035748 | MO | N | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 1265528475 | 05 | MO | MEDICAID | P00800174 | 01 | MO | RR MEDICARE | OTHER | 200630700A | 05 | KS | MEDICAID |