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General NPI Number Information
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NPI Number | 1104459833
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Entity Type | Individual
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Provider Name | ZAKIYA S CLEMOENS NP
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Gender | Female
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Dates
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Enumeration Date | 02/21/2020
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Last Update Date | 07/12/2021
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Provider Practice Location Address
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Address Line | 629 W 101ST TER
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City | KANSAS CITY
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State | MO
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Zip | 64114-4236
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Country | US
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Telephone | 816-914-4065
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Fax |
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Provider Business Mailing Address
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Address Line | 629 W 101ST TER
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City | KANSAS CITY
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State | MO
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Zip | 64114-4236
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Country | US
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Telephone | 816-914-4065
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 2020007316
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 5379289071
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License Number State | KS
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