Healthcare Provider Details

I. General information

NPI: 1982199477
Provider Name (Legal Business Name): RACHEL ENLOE NADON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2018
Last Update Date: 02/22/2021
Certification Date: 02/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6501 E 87TH ST
KANSAS CITY MO
64138-2732
US

IV. Provider business mailing address

6501 E 87TH ST
KANSAS CITY MO
64138-2732
US

V. Phone/Fax

Practice location:
  • Phone: 816-444-8400
  • Fax: 816-444-8407
Mailing address:
  • Phone: 816-444-8400
  • Fax: 816-444-8407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number14-89229-041
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2018021599
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number155819
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: