Healthcare Provider Details

I. General information

NPI: 1396207403
Provider Name (Legal Business Name): ROSE W NJOROGE-LASSITER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ROSE WANJIRU NJOROGE APRN

II. Dates (important events)

Enumeration Date: 04/05/2019
Last Update Date: 04/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3660 SUMMIT ST
KANSAS CITY MO
64111-4632
US

IV. Provider business mailing address

412 NW NOTTINGHAM LN
BLUE SPRINGS MO
64014-1231
US

V. Phone/Fax

Practice location:
  • Phone: 816-931-1196
  • Fax:
Mailing address:
  • Phone: 816-204-8641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2019007956
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: