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General NPI Number Information
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NPI Number | 1629362645
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Entity Type | Individual
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Provider Name | ELIZABETH ANN HENRY NP-C
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Gender | Female
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Dates
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Enumeration Date | 06/07/2011
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Last Update Date | 08/25/2023
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Provider Practice Location Address
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Address Line | 3201 FAIRFAX TRFY
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City | KANSAS CITY
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State | KS
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Zip | 66115-1307
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Country | US
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Telephone | 913-573-7053
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Fax | 913-573-7001
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Provider Business Mailing Address
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Address Line | 12103 STATE ROUTE 7
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City | LAKE LOTAWANA
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State | MO
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Zip | 64086-9165
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Country | US
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Telephone | 816-853-3077
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Fax | 913-573-7001
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 2011017381
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LX0106X
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Taxonomy Name | Occupational Health Nurse Practitioner
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License Number | 53-75912-101
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 53-75912-101
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License Number State | KS
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