Healthcare Provider Details

I. General information

NPI: 1386720373
Provider Name (Legal Business Name): CHRISTINA DAK-WAI DONZE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 11/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 B SOUTH PLATTE CLAY WAY
KEARNEY MO
64060
US

IV. Provider business mailing address

301 B SOUTH PLATTE CLAY WAY
KEARNEY MO
64060
US

V. Phone/Fax

Practice location:
  • Phone: 816-781-4244
  • Fax: 816-781-3542
Mailing address:
  • Phone: 816-903-5373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2001021685
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: