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General NPI Number Information
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NPI Number | 1891440608
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Entity Type | Individual
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Provider Name | KORTNIE DUTHOO FNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/21/2022
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Last Update Date | 06/02/2022
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Provider Practice Location Address
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Address Line | 1420 S 42ND ST
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City | KANSAS CITY
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State | KS
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Zip | 66106-1952
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Country | US
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Telephone | 913-831-1100
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Fax | 913-831-0827
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Provider Business Mailing Address
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Address Line | 2101 PRAIRIE CREEK DR
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City | KEARNEY
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State | MO
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Zip | 64060-7628
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Country | US
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Telephone |
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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 | 2021035675
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5380700021
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License Number State | KS
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