Basic Information
| Provider Information | |||||||||
| NPI: | 1730500265 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRALEY | ||||||||
| FirstName: | MEGHAN | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18640 E 38TH TER S | ||||||||
| Address2: | |||||||||
| City: | INDEPENDENCE | ||||||||
| State: | MO | ||||||||
| PostalCode: | 640572304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8162291191 | ||||||||
| FaxNumber: | 8162291198 | ||||||||
| Practice Location | |||||||||
| Address1: | 5844 NW BARRY RD STE 340 | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641541402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9134919100 | ||||||||
| FaxNumber: | 9134919135 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/31/2013 | ||||||||
| LastUpdateDate: | 07/03/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 2013045538 | MO | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.