Healthcare Provider Details

I. General information

NPI: 1285360222
Provider Name (Legal Business Name): SUSAN GAIL KIGER RN, SANE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2022
Last Update Date: 07/30/2022
Certification Date: 07/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 CLAY EDWARDS DR
NORTH KANSAS CITY MO
64116-3220
US

IV. Provider business mailing address

1418 N CEDAR ST
NEVADA MO
64772-1116
US

V. Phone/Fax

Practice location:
  • Phone: 913-710-0931
  • Fax:
Mailing address:
  • Phone: 913-710-3091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number087158
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: