Healthcare Provider Details

I. General information

NPI: 1578483764
Provider Name (Legal Business Name): ZOHREH KHAKIZAMANI NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 WORNALL RD
KANSAS CITY MO
64111-3241
US

IV. Provider business mailing address

901 E 104TH ST MS 400S
KANSAS CITY MO
64131-4517
US

V. Phone/Fax

Practice location:
  • Phone: 816-932-2000
  • Fax:
Mailing address:
  • Phone: 816-932-3679
  • Fax: 816-932-9089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number2026031362
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number53-85796-031
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: