Healthcare Provider Details

I. General information

NPI: 1437067121
Provider Name (Legal Business Name): LAKENZIE BAILEY-HOUSE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4580 BASS PRO DR
INDEPENDENCE MO
64055-5478
US

IV. Provider business mailing address

4580 BASS PRO DR
INDEPENDENCE MO
64055-5478
US

V. Phone/Fax

Practice location:
  • Phone: 816-651-8571
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number2025004732
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: