Healthcare Provider Details

I. General information

NPI: 1831680842
Provider Name (Legal Business Name): DEANNA MARIE BAFUS NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2018
Last Update Date: 06/04/2024
Certification Date: 05/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 NW RD MIZE ROAD
BLUE SPRINGS MO
64014
US

IV. Provider business mailing address

5101 COLLEGE BLVD
LEAWOOD KS
66211-1614
US

V. Phone/Fax

Practice location:
  • Phone: 816-548-2600
  • Fax:
Mailing address:
  • Phone: 913-392-2246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License NumberF05180237
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: