Healthcare Provider Details

I. General information

NPI: 1265382477
Provider Name (Legal Business Name): HWAJIN LEE
Entity Type: Individual
Gender:
Sole Proprietor: N

Provider Other Name: EVELYN LEE

II. Dates (important events)

Enumeration Date: 01/29/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 HOLMES ST
KANSAS CITY MO
64108-2677
US

IV. Provider business mailing address

2301 HOLMES ST
KANSAS CITY MO
64108-2677
US

V. Phone/Fax

Practice location:
  • Phone: 816-404-1000
  • Fax:
Mailing address:
  • Phone: 816-404-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number2026007722
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: