Healthcare Provider Details

I. General information

NPI: 1619372919
Provider Name (Legal Business Name): GENEA M. RICHARDSON MSN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2014
Last Update Date: 10/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4911 S ARROWHEAD DR SUITE 300
INDEPENDENCE MO
64055-7005
US

IV. Provider business mailing address

8717 W 110TH ST SUITE 600
OVERLAND PARK KS
66210-2144
US

V. Phone/Fax

Practice location:
  • Phone: 816-795-6880
  • Fax: 816-795-5980
Mailing address:
  • Phone: 913-428-2900
  • Fax: 913-428-2951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2014031126
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: