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NPI 1154148237

NPI 1154148237 : KRISTOPHER JAMES TEAGUE : KANSAS CITY, KS

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General NPI Number Information
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    NPI Number           |    1154148237
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    Entity Type          |    Individual 
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    Provider Name        |    KRISTOPHER JAMES TEAGUE
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/20/2024
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    Last Update Date     |    10/04/2024
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Provider Practice Location Address
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    Address Line         |    4000 CAMBRIDGE ST 
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    City                 |    KANSAS CITY
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    State                |    KS
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    Zip                  |    66160-8501
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    Country              |    US
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    Telephone            |    913-588-0000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4000 CAMBRIDGE ST 
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    City                 |    KANSAS CITY
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    State                |    KS
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    Zip                  |    66160-8501
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    Country              |    US
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    Telephone            |    
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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        |    163WN0800X
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    Taxonomy Name        |    Neuroscience Registered Nurse
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    License Number       |    2017024604
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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       |    58-83675-041
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    License Number State |    KS
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