Healthcare Provider Details

I. General information

NPI: 1013959022
Provider Name (Legal Business Name): LINDA GRAHAM CROSSER RN CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 BROADWAY ST
KANSAS CITY MO
64111-3315
US

IV. Provider business mailing address

4440 BROADWAY ST
KANSAS CITY MO
64111-3315
US

V. Phone/Fax

Practice location:
  • Phone: 816-561-9200
  • Fax: 816-561-5766
Mailing address:
  • Phone: 816-561-9200
  • Fax: 816-561-5766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License Number077756
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: