Healthcare Provider Details

I. General information

NPI: 1447745708
Provider Name (Legal Business Name): LAURA ASHLEY VASQUEZ CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2018
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6530 TROOST AVE STE A
KANSAS CITY MO
64131-1301
US

IV. Provider business mailing address

6530 TROOST AVE STE A
KANSAS CITY MO
64131-1301
US

V. Phone/Fax

Practice location:
  • Phone: 816-361-0670
  • Fax: 816-444-6936
Mailing address:
  • Phone: 816-361-0670
  • Fax: 816-444-6936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2018022925
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-78273-082
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: