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General NPI Number Information
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NPI Number | 1508716366
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Entity Type | Organization
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Legal Business Name | STRONG WATER LLC
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Dates
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Enumeration Date | 01/31/2026
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Last Update Date | 01/31/2026
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Provider Practice Location Address
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Address Line | 13830 SANTA FE TRAIL DR STE 106
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City | LENEXA
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State | KS
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Zip | 66215-3381
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Country | US
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Telephone | 806-220-3062
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Fax |
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Provider Business Mailing Address
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Address Line | 921 COPPERLEAF ST
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City | RAYMORE
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State | MO
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Zip | 64083-8736
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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 | PMHNP-BC
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Name | JAMIE SPENCE
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Credential | PMHNP-BC
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Telephone | 806-220-3062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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