Healthcare Provider Details

I. General information

NPI: 1023972924
Provider Name (Legal Business Name): NATHALIE EAMIGUEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3020 S 7TH ST
KANSAS CITY KS
66103-2602
US

IV. Provider business mailing address

3965 W 83RD ST
PRAIRIE VILLAGE KS
66208-5308
US

V. Phone/Fax

Practice location:
  • Phone: 913-258-5322
  • Fax:
Mailing address:
  • Phone: 913-258-5322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: