Healthcare Provider Details

I. General information

NPI: 1083535892
Provider Name (Legal Business Name): CHRISTINA M AMMON LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2026
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 E GREGORY BLVD
KANSAS CITY MO
64114-1119
US

IV. Provider business mailing address

7621 W 96TH TER
OVERLAND PARK KS
66212-2319
US

V. Phone/Fax

Practice location:
  • Phone: 816-608-3384
  • Fax:
Mailing address:
  • Phone: 816-668-8963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number23-56103-121
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: