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General NPI Number Information
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NPI Number | 1386377539
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Entity Type | Individual
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Provider Name | KATELYN WULFF
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Gender | Female
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Dates
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Enumeration Date | 07/06/2022
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Last Update Date | 07/06/2022
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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 | 913-588-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 315 MULBERRY DR
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City | RAYMORE
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State | MO
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Zip | 64083-8297
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2022019012
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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 | 53-81252-042
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License Number State | KS
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