Healthcare Provider Details

I. General information

NPI: 1770942740
Provider Name (Legal Business Name): NATALIE WELLINGTON APRN-NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2016
Last Update Date: 03/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4840 COLLEGE BLVD
OVERLAND PARK KS
66211-1601
US

IV. Provider business mailing address

4840 COLLEGE BLVD
OVERLAND PARK KS
66211-1601
US

V. Phone/Fax

Practice location:
  • Phone: 913-491-6878
  • Fax: 913-491-3172
Mailing address:
  • Phone: 913-491-6878
  • Fax: 913-491-3172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-77105-112
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: