Healthcare Provider Details

I. General information

NPI: 1194796961
Provider Name (Legal Business Name): JANICE GLADMAN RN, MSN,CS, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. JANICE NEAL

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 09/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 RUNNING HORSE ROAD
PLATTE CITY MO
64079-9761
US

IV. Provider business mailing address

2700 CLAY EDWARDS DR SUITE 240
NORTH KANSAS CITY MO
64116-3251
US

V. Phone/Fax

Practice location:
  • Phone: 816-858-2200
  • Fax: 816-858-3611
Mailing address:
  • Phone: 816-691-5287
  • Fax: 816-346-7690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number66677
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: