Healthcare Provider Details

I. General information

NPI: 1073577151
Provider Name (Legal Business Name): CYNTHIA EASTER CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CYNTHIA ROBERTS

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 05/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 S 169 HWY
SMITHVILLE MO
64089
US

IV. Provider business mailing address

901 E 104TH ST MAILSTOP 400N
KANSAS CITY MO
64131-4517
US

V. Phone/Fax

Practice location:
  • Phone: 816-532-3700
  • Fax: 816-532-7163
Mailing address:
  • Phone: 816-502-8752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN061005
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: