Healthcare Provider Details

I. General information

NPI: 1972444891
Provider Name (Legal Business Name): HANNAH JO WYCUFF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 WORNALL RD
KANSAS CITY MO
64111-3241
US

IV. Provider business mailing address

902 E DADE 122
EVERTON MO
65646-7236
US

V. Phone/Fax

Practice location:
  • Phone: 816-932-3100
  • Fax:
Mailing address:
  • Phone: 816-938-6155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: