Provider Demographics
NPI:1174618896
Name:BLUNDELL, KATHRYN MARY (RN, BSN, CNOR, CRNFA)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:MARY
Last Name:BLUNDELL
Suffix:
Gender:F
Credentials:RN, BSN, CNOR, CRNFA
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:MARY
Other - Last Name:YETTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:801 E 30TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64109-1413
Mailing Address - Country:US
Mailing Address - Phone:816-531-2861
Mailing Address - Fax:816-531-2863
Practice Address - Street 1:801 E 30TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64109-1413
Practice Address - Country:US
Practice Address - Phone:816-531-2861
Practice Address - Fax:816-531-2863
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO104838163WR0006X
KS13-55986-051163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant