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General NPI Number Information
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NPI Number | 1659958502
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Entity Type | Individual
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Provider Name | SUSAN LYNN TESTERMAN FNP
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Gender | Female
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Dates
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Enumeration Date | 03/26/2021
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Last Update Date | 02/20/2024
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Provider Practice Location Address
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Address Line | 10940 PARALLEL PKWY STE K152
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City | KANSAS CITY
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State | KS
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Zip | 66109-4434
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Country | US
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Telephone | 816-482-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 7504 NW 73RD PL
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City | KANSAS CITY
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State | MO
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Zip | 64152-4438
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Country | US
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Telephone | 816-728-9981
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2021011107
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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 | 53-80152-032
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License Number State | KS
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