Healthcare Provider Details

I. General information

NPI: 1609028786
Provider Name (Legal Business Name): LILLIAN ARZELIA BUCHANAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2008
Last Update Date: 10/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2734 N 10TH ST
KANSAS CITY KS
66104-5347
US

IV. Provider business mailing address

2734 N 10TH ST
KANSAS CITY KS
66104-5347
US

V. Phone/Fax

Practice location:
  • Phone: 816-655-5741
  • Fax: 816-655-5367
Mailing address:
  • Phone: 816-655-5741
  • Fax: 816-655-5367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number1344449102
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number097904
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: