Healthcare Provider Details

I. General information

NPI: 1225122518
Provider Name (Legal Business Name): PATRICIA A CYRUS ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 LEE'S SUMMIT RD
KANSAS CITY MO
64139
US

IV. Provider business mailing address

7900 LEE'S SUMMIT ROAD
KANSAS CITY MO
64139
US

V. Phone/Fax

Practice location:
  • Phone: 816-404-8557
  • Fax: 816-404-8576
Mailing address:
  • Phone: 816-404-8557
  • Fax: 816-404-8576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number148605
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: