Healthcare Provider Details

I. General information

NPI: 1760248025
Provider Name (Legal Business Name): ANN ELIZABETH BRUER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2024
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5775 NW 64TH TER STE 203
KANSAS CITY MO
64151-3980
US

IV. Provider business mailing address

5775 NW 64TH TER STE 203
KANSAS CITY MO
64151-3980
US

V. Phone/Fax

Practice location:
  • Phone: 816-371-8677
  • Fax:
Mailing address:
  • Phone: 816-371-8677
  • Fax: 816-295-1295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2024007266
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: