Healthcare Provider Details

I. General information

NPI: 1245682939
Provider Name (Legal Business Name): SUNNI R KNEELAND ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2016
Last Update Date: 10/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 SENECA ST STE 646C
BUFFALO NY
14210-1351
US

IV. Provider business mailing address

2310 HOLMES ST STE 800
KANSAS CITY MO
64108-2602
US

V. Phone/Fax

Practice location:
  • Phone: 716-995-4450
  • Fax:
Mailing address:
  • Phone: 816-218-2500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2008020763
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License Number2016025030
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2016025030
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: