Healthcare Provider Details

I. General information

NPI: 1417891318
Provider Name (Legal Business Name): BRIGHTPATH HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8301 STATE LINE RD STE 220
KANSAS CITY MO
64114-2025
US

IV. Provider business mailing address

8301 STATE LINE RD. STE. 220. #3493
KANSAS CITY MO
64114
US

V. Phone/Fax

Practice location:
  • Phone: 314-850-5215
  • Fax: 314-293-6774
Mailing address:
  • Phone: 314-850-5215
  • Fax: 314-293-6774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. TAKEYSHA LARAY LOWE
Title or Position: OWNER
Credential: FNP-C
Phone: 314-850-5215