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General NPI Number Information
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NPI Number | 1881926749
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Entity Type | Individual
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Provider Name | DIANE MARIE BACKHAUS ARNP
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Gender | Female
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Dates
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Enumeration Date | 02/03/2010
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Last Update Date | 08/24/2016
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Provider Practice Location Address
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Address Line | 4700 INDIAN CREEK PKWY
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City | OVERLAND PARK
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State | KS
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Zip | 66207-4068
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Country | US
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Telephone | 913-660-1616
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Fax |
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Provider Business Mailing Address
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Address Line | 10540 MARTY ST STE 100
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City | OVERLAND PARK
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State | KS
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Zip | 66212-2551
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Country | US
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Telephone | 913-660-1616
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 53-75073-041
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 2009036280
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License Number State | MO
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