Healthcare Provider Details

I. General information

NPI: 1962473215
Provider Name (Legal Business Name): MICHELLE ANN GUINTA MSN RN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 11/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 NE SAINT LUKES BLVD STE. 200
LEES SUMMIT MO
64086-6001
US

IV. Provider business mailing address

20 NE SAINT LUKES BLVD STE. 200
LEES SUMMIT MO
64086-6001
US

V. Phone/Fax

Practice location:
  • Phone: 816-347-5100
  • Fax: 816-347-5136
Mailing address:
  • Phone: 816-347-5100
  • Fax: 816-347-5136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number145013
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: