Healthcare Provider Details

I. General information

NPI: 1114737772
Provider Name (Legal Business Name): LUCY W NJOGU NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7501 METCALF AVE
OVERLAND PARK KS
66204-2927
US

IV. Provider business mailing address

18309 SPRUCE ST
GARDNER KS
66030-9457
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax:
Mailing address:
  • Phone: 913-579-8344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number83622
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: