Healthcare Provider Details

I. General information

NPI: 1215599030
Provider Name (Legal Business Name): LINDSEY MICHELLE NITCHALS FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2019
Last Update Date: 02/12/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 CAMBRIDGE ST
INDEPENDENCE MO
64057-2358
US

IV. Provider business mailing address

15310 W 78TH TER
SHAWNEE KS
66217-9615
US

V. Phone/Fax

Practice location:
  • Phone: 816-932-2000
  • Fax:
Mailing address:
  • Phone: 913-219-8009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number119274
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number78740
License Number StateKS
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-78740-082
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: