Healthcare Provider Details

I. General information

NPI: 1700420916
Provider Name (Legal Business Name): HEATHER A RHODES MSN, FPMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER A BUCK

II. Dates (important events)

Enumeration Date: 10/30/2019
Last Update Date: 05/28/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17611 E US HIGHWAY 24
INDEPENDENCE MO
64056-1853
US

IV. Provider business mailing address

17844 E 23RD ST S
INDEPENDENCE MO
64057-1840
US

V. Phone/Fax

Practice location:
  • Phone: 816-254-3652
  • Fax:
Mailing address:
  • Phone: 816-254-3652
  • Fax: 816-257-2575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number13-70739-052
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number53-79222-052
License Number StateKS
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2020032337
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: