Healthcare Provider Details

I. General information

NPI: 1750986626
Provider Name (Legal Business Name): TRUSTED PRIMARY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2020
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 E WEST PLAINS ST
MEADE KS
67864-9738
US

IV. Provider business mailing address

109 E WEST PLAINS ST
MEADE KS
67864-9738
US

V. Phone/Fax

Practice location:
  • Phone: 816-985-1215
  • Fax:
Mailing address:
  • Phone: 816-985-1215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MERRILL ELIZABETH HOOVER
Title or Position: OWNER/PROVIDER
Credential: FNP-BC
Phone: 620-236-3484