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NPI Code Detail

MEDICARE: LAURA BETH MARTIS APRN

MEDICARE: LAURA BETH MARTIS APRN
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
1363LP0222XCritical Care Pediatric Nurse Practitioner2016021959MO
2363LP0222XCritical Care Pediatric Nurse Practitioner53-77295-042KS

General Provider Information

NPI Number : 1194278887
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA BETH MARTIS APRN
Provider Business Mailing Address
First Line : 2401 GILLHAM RD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64108-4619
Country : US
Telephone Number : 816-234-3000
Fax Number :
Provider Business Practice Location Address
First Line : 2401 GILLHAM RD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64108-4619
Country : US
Telephone Number : 816-234-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2016
Last Update Date : 07/28/2016

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