Healthcare Provider Details

I. General information

NPI: 1861105702
Provider Name (Legal Business Name): DANIEL MEYERS FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2023
Last Update Date: 08/02/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 N CHURCH RD
KANSAS CITY MO
64158-1104
US

IV. Provider business mailing address

802 DAVID DR
GALLATIN MO
64640-9474
US

V. Phone/Fax

Practice location:
  • Phone: 816-407-2300
  • Fax: 816-407-2301
Mailing address:
  • Phone: 660-605-1576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2023000186
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: