Healthcare Provider Details

I. General information

NPI: 1679007454
Provider Name (Legal Business Name): KAYLA STRODTMAN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2017
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 S CHURCH ST
FAYETTE MO
65248-1243
US

IV. Provider business mailing address

PO BOX 843966
KANSAS CITY MO
64184-3966
US

V. Phone/Fax

Practice location:
  • Phone: 660-248-2217
  • Fax: 660-248-3450
Mailing address:
  • Phone: 573-884-3300
  • Fax: 573-884-0943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2017019300
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: