Provider Demographics
NPI:1962930156
Name:MCKINNEY, SHARMA CATHERINE PROSSER (FNP-C)
Entity type:Individual
Prefix:
First Name:SHARMA
Middle Name:CATHERINE PROSSER
Last Name:MCKINNEY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4945 ALDEN ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66216-5164
Mailing Address - Country:US
Mailing Address - Phone:913-709-8754
Mailing Address - Fax:
Practice Address - Street 1:13351 S ARAPAHO DRIVE
Practice Address - Street 2:COTTONWOOD SPRINGS
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062
Practice Address - Country:US
Practice Address - Phone:913-353-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-01
Last Update Date:2017-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSF04170291207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine