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General NPI Number Information
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NPI Number | 1891402350
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Entity Type | Individual
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Provider Name | MARTA HAILU KIFLE NP
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Gender | Female
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Dates
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Enumeration Date | 11/03/2022
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 4429 S RIVER BLVD
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City | INDEPENDENCE
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State | MO
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Zip | 64055-4659
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Country | US
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Telephone | 816-768-0090
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Fax |
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Provider Business Mailing Address
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Address Line | 8613 NW 85TH TER
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City | KANSAS CITY
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State | MO
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Zip | 64153-1600
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Country | US
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Telephone | 816-673-6697
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 53-81591-091
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2022035981
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License Number State | MO
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