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General NPI Number Information
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NPI Number | 1356065494
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Entity Type | Individual
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Provider Name | MALLOREE JO FROEHLICH
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Gender | Female
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Dates
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Enumeration Date | 10/03/2022
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 4179 STERLING AVE
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City | KANSAS CITY
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State | MO
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Zip | 64133-1348
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Country | US
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Telephone | 816-780-2870
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Fax |
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Provider Business Mailing Address
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Address Line | 3550 S 4TH ST STE 110
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City | LEAVENWORTH
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State | KS
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Zip | 66048-5061
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Country | US
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Telephone | 816-383-1887
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2022040708
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 53-82063-112
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License Number State | KS
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