Healthcare Provider Details

I. General information

NPI: 1871024711
Provider Name (Legal Business Name): RACHEL MARIE EFFERTZ FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL M PADDOCK

II. Dates (important events)

Enumeration Date: 03/22/2017
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17525 MEDICAL CENTER PKWY
INDEPENDENCE MO
64057-1824
US

IV. Provider business mailing address

17525 MEDICAL CENTER PKWY
INDEPENDENCE MO
64057-1824
US

V. Phone/Fax

Practice location:
  • Phone: 816-994-3150
  • Fax: 816-359-3044
Mailing address:
  • Phone: 816-994-3150
  • Fax: 816-359-3044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2017003584
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-77600-082
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: