Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 2019043933 | MO |
NPI | 1003452764 |
---|---|
Provider Name | Sarah Anne Heavey |
First Address | Kansas City, MO 64131-6002 |
Second Address | Kansas City, MO 64111 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2019 |
Last Update Date | 24/01/2020 |