Healthcare Provider Details

I. General information

NPI: 1952894065
Provider Name (Legal Business Name): SHARON KIRKENDOLL RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2018
Last Update Date: 04/30/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 ROCK CREEK PKWY
KANSAS CITY MO
64117-2520
US

IV. Provider business mailing address

2801 ROCKCREEK PARKWAY MAIL DROP WO411
KANSAS CITY MO
64117-2520
US

V. Phone/Fax

Practice location:
  • Phone: 816-209-4349
  • Fax: 816-936-7826
Mailing address:
  • Phone: 816-201-1905
  • Fax: 816-936-7826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number106414
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: