Healthcare Provider Details

I. General information

NPI: 1194365478
Provider Name (Legal Business Name): SARAH D FOSTER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH D HEENAN FNP-C

II. Dates (important events)

Enumeration Date: 01/14/2020
Last Update Date: 12/07/2022
Certification Date: 12/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2313 NE OLD PAINT RD
LEES SUMMIT MO
64086-7033
US

IV. Provider business mailing address

8550 MARSHALL DR STE 220
LENEXA KS
66214-1505
US

V. Phone/Fax

Practice location:
  • Phone: 816-805-0886
  • Fax:
Mailing address:
  • Phone: 816-348-2260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number202001231
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: