Healthcare Provider Details

I. General information

NPI: 1093785156
Provider Name (Legal Business Name): DONNA JOY MCCLANAHAN RNC, PNP, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 05/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9405 N OAK TRFY
KANSAS CITY MO
64155-2233
US

IV. Provider business mailing address

9405 N OAK TRFY
KANSAS CITY MO
64155-2233
US

V. Phone/Fax

Practice location:
  • Phone: 816-412-2900
  • Fax: 816-412-2915
Mailing address:
  • Phone: 816-412-2900
  • Fax: 816-412-2915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN061329
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: