Healthcare Provider Details

I. General information

NPI: 1659486181
Provider Name (Legal Business Name): MARY ANNE KASER ARNP, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. MARY ANNE BRUDER

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 09/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 N MAIN ST
PLATTSBURG MO
64477-1238
US

IV. Provider business mailing address

1600 E EVERGREEN ST
CAMERON MO
64429-2400
US

V. Phone/Fax

Practice location:
  • Phone: 816-539-3366
  • Fax: 816-539-2866
Mailing address:
  • Phone: 816-632-2101
  • Fax: 816-649-3383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2003017718
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number46124
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number14-102738-021
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: