Healthcare Provider Details

I. General information

NPI: 1992894133
Provider Name (Legal Business Name): CINDY KAY OETTING RDLDCDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 WORNALL RD
KANSAS CITY MO
64111-3220
US

IV. Provider business mailing address

4401 WORNALL RD
KANSAS CITY MO
64111-3220
US

V. Phone/Fax

Practice location:
  • Phone: 816-932-8253
  • Fax: 816-932-3955
Mailing address:
  • Phone: 816-932-8253
  • Fax: 816-932-3955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2003011305
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number000566
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number2003011305
License Number StateMO
# 4
Primary TaxonomyN
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number000566
License Number StateKS
# 5
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number2003011305
License Number StateMO
# 6
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number000566
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: