Healthcare Provider Details

I. General information

NPI: 1699761767
Provider Name (Legal Business Name): KRISTIN LEE STITT ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 A HWY
LIBERTY MO
64068-7129
US

IV. Provider business mailing address

1530 A HWY
LIBERTY MO
64068-7129
US

V. Phone/Fax

Practice location:
  • Phone: 816-415-1900
  • Fax: 816-415-1800
Mailing address:
  • Phone: 816-415-1900
  • Fax: 816-415-1800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number126759
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: