Healthcare Provider Details

I. General information

NPI: 1366224016
Provider Name (Legal Business Name): AMBER C MAGGARD APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2023
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 W 8TH ST
KANSAS CITY MO
64105-1513
US

IV. Provider business mailing address

725 SW 33RD ST
LEES SUMMIT MO
64082-4151
US

V. Phone/Fax

Practice location:
  • Phone: 816-605-1949
  • Fax: 417-512-2196
Mailing address:
  • Phone: 816-606-9151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number2023041403
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: