Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 2018020163 | MO |
NPI | 1003301490 |
---|---|
Provider Name | Stephanie Anne Meyer |
First Address | North Kansas City, MO 64116-3254 |
Second Address | North Kansas City, MO 64116-3254 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2018 |
Last Update Date | 01/09/2020 |