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Lara Lenea Kaljumaa

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

1900 N Amidon Ave Ste 210, Wichita, KS 67203-2137

PECOS Enrollment

This provider is enrolled in PECOS as LARA KALJUMAA.

Based on the most recent information from CMS, provider Lara Lenea Kaljumaa is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1699293084
Provider Type
Individual
Full Name
Kaljumaa, Lara Lenea
Title
Mrs.
Credential
APRN

Gender
Female
Sole Proprietor
No
Enumeration Date
9/6/2017
Last Updated
9/6/2017

Contact Information

Practice Location

1900 N Amidon Ave Ste 210, Wichita, KS 67203-2137

(316) 260-4110

Unlisted Fax

Mailing Location

1900 N Amidon Ave Ste 210, Wichita, KS 67203-2137

(316) 260-4110

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 77833 Kansas

Lara Lenea Kaljumaa

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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