Healthcare Provider Details

I. General information

NPI: 1154265155
Provider Name (Legal Business Name): SUZANNE MAUREEN CLEMONS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2790 CLAY EDWARDS DRIVE, SUITE 520/570
NORTH KANSAS CITY MO
64116-3220
US

IV. Provider business mailing address

2800 CLAY EDWARDS DRIVE, CENTRAL VERIFICATION OFFICE AND PAYOR ENROLLMENT
NORTH KANSAS CITY MO
64116
US

V. Phone/Fax

Practice location:
  • Phone: 816-221-6750
  • Fax: 816-221-7280
Mailing address:
  • Phone: 816-221-6750
  • Fax: 816-221-7280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2026008966
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: