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General NPI Number Information
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NPI Number | 1275370637
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Entity Type | Individual
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Provider Name | MODESTINE RAE POWERS FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/12/2024
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 5440 NW 64TH ST
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City | KANSAS CITY
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State | MO
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Zip | 64151-2415
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Country | US
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Telephone | 866-389-2727
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Fax |
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Provider Business Mailing Address
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Address Line | 8450 NW PRAIRIE VIEW RD # 1107
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City | KANSAS CITY
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State | MO
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Zip | 64153-1841
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Country | US
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Telephone | 816-797-9735
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Fax | 816-207-0624
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 53-83882-022
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2024036127
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License Number State | MO
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