Healthcare Provider Details

I. General information

NPI: 1821578501
Provider Name (Legal Business Name): AMANDA HOCKER CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2018
Last Update Date: 12/23/2020
Certification Date: 12/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 CARONDELET DR
KANSAS CITY MO
64114-4673
US

IV. Provider business mailing address

PO BOX 414796
KANSAS CITY MO
64141-4796
US

V. Phone/Fax

Practice location:
  • Phone: 816-943-3926
  • Fax: 816-943-3170
Mailing address:
  • Phone: 913-647-4100
  • Fax: 913-647-4120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number2018019045
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: