Healthcare Provider Details

I. General information

NPI: 1124493507
Provider Name (Legal Business Name): EMILY LIER AGACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2015
Last Update Date: 03/29/2023
Certification Date: 03/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 NE SAINT LUKES BLVD STE 220
LEES SUMMIT MO
64086-6011
US

IV. Provider business mailing address

120 NE SAINT LUKES BLVD STE 220
LEES SUMMIT MO
64086-6011
US

V. Phone/Fax

Practice location:
  • Phone: 816-932-7900
  • Fax: 816-932-7920
Mailing address:
  • Phone: 816-932-7900
  • Fax: 816-932-7920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number2015042860
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number2015042860
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: