Healthcare Provider Details

I. General information

NPI: 1114465457
Provider Name (Legal Business Name): ELIZABETH BERTSCHY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2017
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1980 SE BLUE PKWY STE 2110
LEES SUMMIT MO
64063-1074
US

IV. Provider business mailing address

5100 W 110TH ST STE 120
OVERLAND PARK KS
66211-1215
US

V. Phone/Fax

Practice location:
  • Phone: 913-234-7600
  • Fax: 816-361-5775
Mailing address:
  • Phone: 913-234-7600
  • Fax: 816-361-5775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2017003632
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number53-77569-101
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: