Healthcare Provider Details

I. General information

NPI: 1164648952
Provider Name (Legal Business Name): CHRISTI J LEDO FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 03/20/2020
Certification Date: 03/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 BROADWAY BLVD STE 520
KANSAS CITY MO
64111-3342
US

IV. Provider business mailing address

12330 METCALF AVE STE 420
OVERLAND PARK KS
66213-1307
US

V. Phone/Fax

Practice location:
  • Phone: 816-960-7601
  • Fax: 816-960-7699
Mailing address:
  • Phone: 816-960-7690
  • Fax: 816-960-7691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number144021
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: