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NPI Code Detail

MEDICARE: MICHELE SUBLETTE

MEDICARE: MICHELE SUBLETTE
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
1363LF0000XFamily Nurse Practitioner45374KS

General Provider Information

NPI Number : 1164670436
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELE SUBLETTE
Provider Business Mailing Address
First Line : 340 SOUTHWEST BLVD
Second Line :
City : KANSAS CITY
State : KS
Zip : 66103-2150
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 340 SOUTHWEST BLVD
Second Line :
City : KANSAS CITY
State : KS
Zip : 66103-2150
Country : US
Telephone Number : 913-722-3100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2008
Last Update Date : 08/28/2008

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