Healthcare Provider Details

I. General information

NPI: 1821024688
Provider Name (Legal Business Name): KERRI LYNN KEBERLEIN-LYNN ARNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 04/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6420 N PROSPECT AVE
GLADSTONE MO
64119
US

IV. Provider business mailing address

2330 SHAWNEE MISSION PKWY MEDICAL ADMINISTRATIVE SERVICES OF KU MED, STE. 312
WESTWOOD KS
66205-2005
US

V. Phone/Fax

Practice location:
  • Phone: 913-945-9700
  • Fax: 913-945-9707
Mailing address:
  • Phone: 913-588-9000
  • Fax: 913-588-9822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number44287
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number154978
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: