Healthcare Provider Details

I. General information

NPI: 1609502814
Provider Name (Legal Business Name): TRACEY ELEANOR HURLEY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2022
Last Update Date: 09/11/2025
Certification Date: 11/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W 47TH ST STE 514
KANSAS CITY MO
64112-1247
US

IV. Provider business mailing address

800 W 47TH ST STE 514
KANSAS CITY MO
64112-1247
US

V. Phone/Fax

Practice location:
  • Phone: 816-216-7054
  • Fax:
Mailing address:
  • Phone: 816-216-7054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number53-81310-062
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: