Provider Demographics
NPI:1689138588
Name:ARENDS, TAYLOR RENEA (PA-C)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:RENEA
Last Name:ARENDS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:RENEA
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:901 E 104TH ST
Mailing Address - Street 2:MAILSTOP 400S
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-4517
Mailing Address - Country:US
Mailing Address - Phone:816-932-5678
Mailing Address - Fax:816-932-7957
Practice Address - Street 1:4400 BROADWAY BLVD STE 520
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3342
Practice Address - Country:US
Practice Address - Phone:816-960-7600
Practice Address - Fax:816-960-7699
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-24
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-02366363A00000X
MO2020031347363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant