MEDICARE: MRS. ANNA MAIZLIN APRN, ANP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	2014001693	MO
2	363LA2200X	Adult Health Nurse Practitioner	76257	KS

General Provider Information

NPI Number	:	1639594864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANNA MAIZLIN APRN, ANP-BC

Provider Business Mailing Address
First Line	:	8717 W 110TH ST STE 600
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66210-2126
Country	:	US
Telephone Number	:	913-428-2900
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 NE MISSOURI RD STE 306
Second Line	:
City	:	LEES SUMMIT
State	:	MO
Zip	:	64086-4715
Country	:	US
Telephone Number	:	913-428-2900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/25/2014
Last Update Date	:	12/20/2022

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