Healthcare Provider Details

I. General information

NPI: 1992194807
Provider Name (Legal Business Name): MAEVE HODES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MAEVE BRENNAN NP

II. Dates (important events)

Enumeration Date: 01/15/2015
Last Update Date: 01/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 NE SAINT LUKES BLVD STE 500
LEES SUMMIT MO
64086-6000
US

IV. Provider business mailing address

901 E 104TH ST MAILSTOP 400N
KANSAS CITY MO
64131-4517
US

V. Phone/Fax

Practice location:
  • Phone: 816-932-3300
  • Fax:
Mailing address:
  • Phone: 816-502-8755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2015001140
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: