Healthcare Provider Details

I. General information

NPI: 1649687971
Provider Name (Legal Business Name): KIMBERLY D SWOPES FNP-C, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2014
Last Update Date: 08/17/2021
Certification Date: 08/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9151 NE 81ST TER STE. 100
KANSAS CITY MO
64158-1294
US

IV. Provider business mailing address

9784 N ASH AVE
KANSAS CITY MO
64157-9742
US

V. Phone/Fax

Practice location:
  • Phone: 816-781-4740
  • Fax: 816-781-0971
Mailing address:
  • Phone: 816-781-4244
  • Fax: 816-781-3542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2014016881
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number2014016881
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: