=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487056354
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LAURA MARIE GRIER APRN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/22/2014
-----------------------------------------------------
Last Update Date | 12/26/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3001 E ELM ST
-----------------------------------------------------
City | HARRISONVILLE
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64701-1196
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-380-6525
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 18501 W 114TH ST
-----------------------------------------------------
City | OLATHE
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66061-9365
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 763-234-0698
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 2014033138
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 76487
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------