Healthcare Provider Details

I. General information

NPI: 1922860253
Provider Name (Legal Business Name): JANELLE SUZANNE KOCHUYT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2024
Last Update Date: 01/23/2024
Certification Date: 01/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10842 MCGEE ST
KANSAS CITY MO
64114-5018
US

IV. Provider business mailing address

10842 MCGEE ST
KANSAS CITY MO
64114-5018
US

V. Phone/Fax

Practice location:
  • Phone: 816-708-0540
  • Fax:
Mailing address:
  • Phone: 816-708-0540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: