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General NPI Number Information
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NPI Number | 1215742192
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Entity Type | Individual
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Provider Name | LUCY OLIPHANT
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Gender | Female
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 4801 E LINWOOD BLVD
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City | KANSAS CITY
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State | MO
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Zip | 64128-2226
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Country | US
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Telephone | 816-922-2641
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Fax |
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Provider Business Mailing Address
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Address Line | 409 N BYNUM RD
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City | LONE JACK
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State | MO
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Zip | 64070-9588
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Country | US
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Telephone | 910-797-9530
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 2023030345
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License Number State | MO
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