Basic Information
| Provider Information | |||||||||
| NPI: | 1639638125 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BAPTISTE | ||||||||
| FirstName: | DESTE | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | DNP FNP-C | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | BAPTISTE | ||||||||
| OtherFirstName: | DESTE | ||||||||
| OtherMiddleName: | D | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | DNP | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 14091 S MULLEN ST | ||||||||
| Address2: | |||||||||
| City: | OLATHE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660626131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9132019106 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 23450 COLLEGE BLVD | ||||||||
| Address2: | |||||||||
| City: | OLATHE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660618702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9137647788 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2019 | ||||||||
| LastUpdateDate: | 03/03/2020 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | M | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/03/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 53-78902-081 | KS | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 2019032025 | MO | N | Allopathic & Osteopathic Physicians | Family Medicine | 363LF0000X | 53-78902 | KS | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.