Healthcare Provider Details

I. General information

NPI: 1548065717
Provider Name (Legal Business Name): VIRGINIA ELIZABETH WILSON-HAYES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2025
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 E LINWOOD BLVD
KANSAS CITY MO
64128-2226
US

IV. Provider business mailing address

3116 CHARLOTTE ST
KANSAS CITY MO
64109-1708
US

V. Phone/Fax

Practice location:
  • Phone: 816-922-3399
  • Fax: 816-922-4815
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2017009489
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: