Healthcare Provider Details

I. General information

NPI: 1700599081
Provider Name (Legal Business Name): SARA D SPEAKER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS SARA D IRBY

II. Dates (important events)

Enumeration Date: 01/02/2023
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 WOLLARD BLVD
RICHMOND MO
64085-2229
US

IV. Provider business mailing address

907 MAPLE ST
KEARNEY MO
64060-7542
US

V. Phone/Fax

Practice location:
  • Phone: 816-776-2201
  • Fax: 816-776-7678
Mailing address:
  • Phone: 816-808-7113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2022047900
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: