Healthcare Provider Details

I. General information

NPI: 1235134776
Provider Name (Legal Business Name): DOUGLAS A SCHELL APRN, MSCN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 BROADWAY STE 520
KANSAS CITY MO
64111-3342
US

IV. Provider business mailing address

901 E 104TH ST MAILSTOP 400S
KANSAS CITY MO
64131
US

V. Phone/Fax

Practice location:
  • Phone: 816-960-7600
  • Fax: 816-960-7699
Mailing address:
  • Phone: 816-502-7117
  • Fax: 816-932-9670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number74751
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code364SM0705X
TaxonomyMedical-Surgical Clinical Nurse Specialist
License Number2000164066
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: