Healthcare Provider Details

I. General information

NPI: 1588458475
Provider Name (Legal Business Name): ANNE KISATO APRN,FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2025
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1616 N 7 HWY
BLUE SPRINGS MO
64014-1936
US

IV. Provider business mailing address

1616 N 7 HWY
BLUE SPRINGS MO
64014-1936
US

V. Phone/Fax

Practice location:
  • Phone: --
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2025011325
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: