Provider Demographics
NPI:1285603704
Name:ARAKELOVA, NINA (MD)
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:ARAKELOVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 14143
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66285-4143
Mailing Address - Country:US
Mailing Address - Phone:913-634-3540
Mailing Address - Fax:913-825-6358
Practice Address - Street 1:9100 W 74TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66204-4004
Practice Address - Country:US
Practice Address - Phone:913-322-6675
Practice Address - Fax:913-766-0021
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002014657207R00000X
KS04-30422208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205869324Medicaid
KS100426090CMedicaid
KSP00240592Medicare PIN
MOS76B822AMedicare PIN
KS100426090CMedicaid
KSKA1399001Medicare PIN