MEDICARE: JOYCE E DORSSOM ARNP

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	44924 ARNP	KS

General Provider Information

NPI Number	:	1750397733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOYCE E DORSSOM ARNP

Provider Business Mailing Address
First Line	:	6000 M LEAVENWORTH RD
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66104
Country	:	US
Telephone Number	:	913-299-0089
Fax Number	:	913-299-0873

Provider Business Practice Location Address
First Line	:	8919 PARALLEL PARKWAY
Second Line	:	SUITE 555
City	:	KANSAS CITY
State	:	KS
Zip	:	66104
Country	:	US
Telephone Number	:	913-788-7099
Fax Number	:	913-788-7065

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

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	07/08/2007

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