Healthcare Provider Details

I. General information

NPI: 1356678288
Provider Name (Legal Business Name): STEPHANIE FRANCES ROEHM ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2009
Last Update Date: 06/25/2021
Certification Date: 06/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10870 BENSON DR STE 2160
OVERLAND PARK KS
66210-1509
US

IV. Provider business mailing address

830 E MAIN ST
GARDNER KS
66030-1287
US

V. Phone/Fax

Practice location:
  • Phone: 833-357-3227
  • Fax: 855-299-2184
Mailing address:
  • Phone: 913-856-4437
  • Fax: 913-856-4330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number53-74992-071
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: