Healthcare Provider Details

I. General information

NPI: 1295069706
Provider Name (Legal Business Name): FAITH A CORDLE RN, ACNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2009
Last Update Date: 11/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4330 WORNALL RD SUITE 2000
KANSAS CITY MO
64111-3201
US

IV. Provider business mailing address

901 E 104TH ST MAILSTOP 400S
KANSAS CITY MO
64131
US

V. Phone/Fax

Practice location:
  • Phone: 816-931-1883
  • Fax:
Mailing address:
  • Phone: 816-502-7117
  • Fax: 816-932-9670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number2003002763
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: