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NPI Code Detail

MEDICARE: DR. MICHELLE GRAVLIN TWITTY PHARM.D., BCPP

MEDICARE: DR. MICHELLE GRAVLIN TWITTY PHARM.D., BCPP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P1300XPsychiatric Pharmacist043906MO

General Provider Information

NPI Number : 1063419919
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHELLE GRAVLIN TWITTY PHARM.D., BCPP
Provider Business Mailing Address
First Line : 5050 MAIN ST APT 608
Second Line :
City : KANSAS CITY
State : MO
Zip : 64112-2884
Country : US
Telephone Number : 573-808-2531
Fax Number :
Provider Business Practice Location Address
First Line : 4801 E LINWOOD BLVD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64128-2226
Country : US
Telephone Number : 816-861-4700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 01/13/2023

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