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General NPI Number Information
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NPI Number | 1639681372
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Entity Type | Individual
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Provider Name | MARK A BATTIST
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Gender | Male
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Dates
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Enumeration Date | 11/03/2017
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Last Update Date | 05/04/2025
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Provider Practice Location Address
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Address Line | 1500 W FOXWOOD DR STE B
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City | RAYMORE
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State | MO
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Zip | 64083-9372
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Country | US
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Telephone | 913-302-7183
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Fax | 888-779-3217
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Provider Business Mailing Address
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Address Line | 12120 STATE LINE RD # 296
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City | LEAWOOD
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State | KS
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Zip | 66209-1254
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Country | US
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Telephone | 913-302-7183
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Fax | 888-779-3217
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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 | 13-119981
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License Number State | KS
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