Healthcare Provider Details

I. General information

NPI: 1457953705
Provider Name (Legal Business Name): ROBERT LOUIS TUTTLE III APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2020
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20375 W 151ST ST STE 463
OLATHE KS
66061-7210
US

IV. Provider business mailing address

14310 E 42ND ST S STE 600
INDEPENDENCE MO
64055-7308
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-1227
  • Fax:
Mailing address:
  • Phone: 816-333-9200
  • Fax: 816-333-9444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number53-79278-011
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number53-79278-011
License Number StateKS
# 3
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number2020008737
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: