Healthcare Provider Details

I. General information

NPI: 1023815651
Provider Name (Legal Business Name): CLAIRE ROSE DEEGAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2025
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2750 CLAY EDWARDS DR STE 410
NORTH KANSAS CITY MO
64116-3258
US

IV. Provider business mailing address

2750 CLAY EDWARDS DR STE 410
NORTH KANSAS CITY MO
64116-3258
US

V. Phone/Fax

Practice location:
  • Phone: 816-471-8114
  • Fax: 816-842-5342
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: