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General NPI Number Information
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NPI Number | 1740142405
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Entity Type | Organization
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Legal Business Name | KANSAS CITY VA
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 4801 E LINWOOD BLVD
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City | KANSAS CITY
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State | MO
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Zip | 64128-2226
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Country | US
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Telephone | 816-861-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 807 S PEARL ST
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City | PAOLA
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State | KS
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Zip | 66071-1950
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Country | US
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Telephone | 816-861-4700
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Fax |
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Authorized Official
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Title or Position | HEALTH AND WELLNESS COACH
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Name | MRS. SHEILA DEEANN ROTH
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Credential |
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Telephone | 816-349-4879
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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