Healthcare Provider Details

I. General information

NPI: 1932739620
Provider Name (Legal Business Name): KRISTIN ANN CECIL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2020
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 N RIVERSIDE RD STE 150
SAINT JOSEPH MO
64507-2508
US

IV. Provider business mailing address

14450 SUMMIT RDG
PARKVILLE MO
64152-2768
US

V. Phone/Fax

Practice location:
  • Phone: 816-271-4025
  • Fax: 816-271-4026
Mailing address:
  • Phone: 913-708-4997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2020002135
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2020002135
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: