Healthcare Provider Details
I. General information
NPI: 1295769180
Provider Name (Legal Business Name): CATHERINE J BANES FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/10/2006
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4330 WORNALL RD STE 2000
KANSAS CITY MO
64111-5939
US
IV. Provider business mailing address
901 E 104TH ST # MS 400S
KANSAS CITY MO
64131-4517
US
V. Phone/Fax
- Phone: 816-931-1883
- Fax:
- Phone: 816-931-1883
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 089525 |
| License Number State | MO |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 5378346 |
| License Number State | KS |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: