Healthcare Provider Details

I. General information

NPI: 1598880684
Provider Name (Legal Business Name): LAUREL ESPINOSA REYNOLDS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 01/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6440 NIEMAN RD
SHAWNEE KS
66203-3326
US

IV. Provider business mailing address

6000 LAMAR AVE SUITE 130
MISSION KS
66202-3234
US

V. Phone/Fax

Practice location:
  • Phone: 913-826-4200
  • Fax: 913-826-1589
Mailing address:
  • Phone: 913-826-4200
  • Fax: 913-826-1589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number14-92141-032
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number46092
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: