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General NPI Number Information
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NPI Number | 1154736445
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Entity Type | Individual
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Provider Name | CONCILIA AMAONYE I
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Gender | Female
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Dates
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Enumeration Date | 06/25/2014
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Last Update Date | 04/05/2022
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Provider Practice Location Address
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Address Line | 2205 WEST 36 AV
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City | KANSAS CITY
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State | KS
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Zip | 66103
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Country | US
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Telephone | 816-295-1826
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Fax |
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Provider Business Mailing Address
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Address Line | 1301 SW PEBBLE LN
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City | LEES SUMMIT
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State | MO
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Zip | 64082-4418
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Country | US
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Telephone | 816-295-1826
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2021033510
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License Number State | KS
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