Healthcare Provider Details

I. General information

NPI: 1780348326
Provider Name (Legal Business Name): ANNIE TAMAYO WRIGHT APRN PNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNIE NICHOLE TAMAYO APRN, CPNP-PC

II. Dates (important events)

Enumeration Date: 10/29/2021
Last Update Date: 02/27/2023
Certification Date: 02/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 GILLHAM RD
KANSAS CITY MO
64108-4619
US

IV. Provider business mailing address

2401 GILLHAM RD
KANSAS CITY MO
64108-4619
US

V. Phone/Fax

Practice location:
  • Phone: 816-234-3395
  • Fax: 816-302-9624
Mailing address:
  • Phone: 816-234-3395
  • Fax: 816-302-9624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number2007029225
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number5380216091
License Number StateKS
# 3
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number2021016502
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: