Healthcare Provider Details

I. General information

NPI: 1083710339
Provider Name (Legal Business Name): EDONNA SYLVIA A.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 RAINBOW BLVD 4070 DELP MAIL STOP 4010
KANSAS CITY KS
66160
US

IV. Provider business mailing address

3901 RAINBOW BLVD 4070 DELP MAIL STOP 4010
KANSAS CITY KS
66160
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-1908
  • Fax:
Mailing address:
  • Phone: 913-588-1908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number44409
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: