Healthcare Provider Details

I. General information

NPI: 1932510195
Provider Name (Legal Business Name): MARY KRISTIN DAVIS BIMEAL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARY KRISTIN DAVIS

II. Dates (important events)

Enumeration Date: 05/09/2014
Last Update Date: 06/07/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9800 TROUP AVE
KANSAS CITY KS
66111-1870
US

IV. Provider business mailing address

1035 FIRETREE AVE
BALDWIN CITY KS
66006-4173
US

V. Phone/Fax

Practice location:
  • Phone: 913-297-7472
  • Fax:
Mailing address:
  • Phone: 785-317-2986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-76240-052
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: