Provider Demographics
NPI:1679087423
Name:KOCHIPILLAI, LIZY MARY (APRN)
Entity type:Individual
Prefix:MS
First Name:LIZY
Middle Name:MARY
Last Name:KOCHIPILLAI
Suffix:
Gender:F
Credentials:APRN
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Mailing Address - Street 1:PO BOX 875743
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64187-5743
Mailing Address - Country:US
Mailing Address - Phone:816-332-7280
Mailing Address - Fax:816-447-3932
Practice Address - Street 1:10977 GRANADA LN STE 105
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1415
Practice Address - Country:US
Practice Address - Phone:913-215-5008
Practice Address - Fax:816-447-3960
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-30
Last Update Date:2017-12-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS53-77856363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty